Cryosurgery – What It Is and How We Use It
Our goal at Aadvanced Footcare Associates is to provide you and your loved ones with the best possible podiatric care. We want you to overcome foot and ankle problems so you can go back to performing favorite activities and, more importantly, not have to endure painful symptoms.
To achieve effective results, we utilize an array of technological treatments – including cryosurgery.
Now, the specifics of our cryosurgery procedures for foot problems might be state-of-the-art, but cold therapy has been a valuable medical tool for centuries. Lowered temperatures reduce inflammation by causing vasoconstriction of blood vessels. Further, ice produces an anesthetic effect by altering nerve function in an appropriate manner.
Between pain relief and reduced inflammation, it’s no wonder as to why doctors, physical therapists, and sports trainers treat so many musculoskeletal injuries and conditions with ice regimens. This is especially beneficial during early inflammatory phases.
Of course, cryosurgery goes well beyond this simple, yet highly effective practice. This has been bolstered by researcher who’ve observed that extreme freezing produces an anesthetic effect that extends beyond the temporary pain relief offered by a simple cooling.
One area you might identify with cryosurgery is wart removal. Up until around the 1960’s, the devices medical professionals had available were not particularly efficient and could only freeze up to a depth of several millimeters. As such, freezing was mainly used to treat skin lesions and growths (like warts).
The development of new instrumentation and technology opened the doors for cold therapy to be more widely used in the field of medicine.
Over the past ten years or so, cryosurgery has started being used to relieve lumbosacral pain, trigeminal nerve pain, and even carpal tunnel syndrome. Going back thirty years, various modalities were introduced by pain management specialists, surgeons, and neurosurgeons to address chronic pain. Techniques used by these medical professionals demonstrated an ability to produce prolonged nerve blocks – which can relieve intractable pain!
If you’re a fan of technological advancement, this is a very exciting field. More than that, cryosurgery is something we are pleased to offer at Aadvanced Footcare Associates.
So, what exactly is cryosurgery? And what foot conditions can it treat?
Well, this is a surgical technique wherein freezing is used to anesthetize (numb) a specific area or to destroy undesirable tissues that are causing problems. The specific procedure will depend on the condition being treated.
In the case of soft tissue and nerve injuries, a freezing probe is applied to injured or damaged tissues. The freezing extends outward from the site of application, which means the amount of tissue affected is greater than just the point of contact with the probe.
Some of the foot and ankle conditions that can be treated with cryosurgery include:
- Plantar fasciitis. This is the most common cause of adult heel pain and a 2007 study reported an eight-fold improvement in pain a full year following a cryosurgical procedure.
- Tarsal tunnel syndrome. When nerves running through the tarsal tunnels in feet—which can be thought of as being similar to the carpal tunnels in the wrists—are compressed, it can cause burning, tingling, and other types of nerve pain. In Podiatry Today, there is a documented success rate of around 50% for cryosurgery when it’s used to treat tarsal tunnel pain. That said, they do further note that additional studies should be performed to establish optimal freeze times for these particular procedures.
- These bundles of irritated nerve endings can cause an array of painful neuropathic symptoms. Traditional nerve surgeries to address the problem can potentially lead to “stump neuromas” developing, but this is not the case for cryosurgery.
- Ankle sprains. Whereas plantar fasciitis is the leading cause of heel pain, ankle sprains are perhaps the single-most common injury of them all. According to a study published in the American Journal of Sports Medicine, Grade IV sprains where healed to the point of full mobility in an average of 13.2 days with the use of cryotherapy, as compared to 33.3 days with a more conservative heat treatment.
We’ve already touched on this a bit with tarsal tunnel syndrome and neuromas, but cryosurgery is particularly beneficial in treated nerve injuries. Unlike with traditional procedures—any of which might inadvertently damage a nerve—cryosurgery leaves the outer shell intact as it freezes the innermost parts of the nerve (those responsible for communicating painful signals to the spinal cord and brain).
In addition to nonexistent risk of nerves being cut, the freezing leads to neural regeneration during the 6-12 months following the procedure. And if any nerves do cause recurrent pain, we can freeze them again to take away the pain – without any adverse effects.
Advantages to cryosurgery for foot problems:
- In-office procedure
- Minimally invasive
- The procedures are painless (performed under local anesthesia)
- Reduced-to-eliminated risk for nerve damage potentially sustained during traditional surgery
- Bypasses prolonged use of pain medications that might otherwise create other systemic complication
- Most patients are able to walk around (ambulatory) the day of the procedure
- Minimal-to-no down time from work or activity
We can perform cryosurgery in our office. The procedure only takes between 15 to 30 minutes. Because of the numbing effect of the ice therapy, no special anesthesia is required (just local anesthesia block in the office) and as such, the procedure is comfortably performed in the office.
First, the area of pain is mapped on the skin. We begin the surgery by administering a local anesthetic and making an incision so small that no sutures are needed. An instrument called a trocar will then guide a cryoprobe to the affected area. This is confirmed with an ultrasound image.
We will then administer a three-minute freeze, followed by a 30-second defrost and another three-minute freeze. At that point, the probe is removed and an antiseptic is applied (along with a light dressing to prevent infection). No stitches are required!
Please be aware that even though you can walk afterwards, you will need to limit major activity for at least 48 hours. It is important to note that every person is different and some patients do take longer to heal. There will likely be a certain degree of minor soreness, and this can increase with too much activity.
Swimming or soaking the affected foot are not allowed until the tiny opening has closed completely.
It is not typical to experience immediate relief after the procedure. Reason for this is the fact it takes time for the nerve to regenerate and surgical site to heal. Also, the body’s natural healing response is not instantaneous. So, you will likely have relief in the future, but it might take a couple of weeks to reach this point.
Once you do find relief, it is often long-lasting. Nerves usually regenerate with a minimal amount of inflammation.
In order to reduce inflammation in the fascia—when we are treating plantar fasciitis—we may recommend a pair of custom orthotics. This supplementary therapy can prevent heel pain recurrence by maintaining natural foot structure and function.
For more information or to request an appointment for cryosurgery consultation, contact our team at Aadvanced Footcare Associates by calling:
- Our Rego Park office at (718) 896-4433
- Our Plainview office at (516) 822-9595
- Our Flushing office at (718) 969-2266