The foot and ankle associates of North Carolina, PLLC have 4 certified cryostar surgeons to perform cryosurgery. Cryoanalgesia is a specialized technique for providing long-term relief for various foot ailments. People have recognized the value of cold for analgesia for thousands of years. Hippocrates left us the first written records of the use of ice for pain relief. Modern Cryoanalgesia as we know it today was developed in the 1960s. This technique is superior to other methods of peripheral nerve destruction (alcohol injections, phenol applications or surgical resection) because it is not followed by neuritis and neuralgia. Past treatment with surgical resection oftentimes lead to recurrent nerve growths called neuromas which could be more painful than the original problem. In addition, narcotic medication do not treat nerve pain, but rather "mask" the pain.
The application of cold to tissues creates a conduction block. This is similar to the effect of local anesthetics, but the effect is long-lasting. Long term pain relief from nerve freezing occurs because the formation of the ice crystals disrupts the sensory component of the nerve structure.
The Cryomed Corporation from England has developed the Cryostar. Over the past three years, its use for podiatric-related condition has been extensively tested for safe, effective and proven pain relief. The Cryostar was approved by the FDA for use in podiatric ailments in July 2003. Since bringing this "state-of-the-art technology" to the podiatric arena, only a select group of Cryostar Certified Podiatric Physicians are qualified and demonstrate the necessary expertise to treat these painful foot conditions. The physicians at The Foot and Ankle Associates of North Carolina are chosen to be of these select few.
Cryosurgery is an office-based procedure that is minimally invasive and takes only 15 minutes to perform. The area experiencing pain will have a local anesthetic injected so that the cryoprobe can be introduced without discomfort. A tiny puncture is made through the skin, then a blunt instrument called a trocar is placed through the puncture site to create a portal for the cryoprobe to be introduced. The probe is inserted through the puncture site and the Cryostar is set for a 3 minute freeze cycle, followed by a 30 second defrost, then another 3 minute freeze. The probe is then removed. An antibiotic ointment is placed over the puncture site with a sterile dressing applied (sutures are not necessary due to small size of the puncture). The dressing may be removed in 24 hours and a shower is permitted. The puncture site is to be covered with a small amount of antibiotic ointment and a Band-Aid. Postoperative discomfort is minimal. It is suggested that you decrease your normal level of activity over the first 48 hours. A follow-up visit will then be scheduled.
INDICATIONS FOR CRYOSURGERY
With medical advancement and expansion of treatment options, it has been found that the Cryostar can be used to treat many foot problems:
- Nerve entrapment (Tarsal Tunnel Syndrome)
- Diabetic peripheral neuropathy (burning, numbness, tingling of toes)
- Osteoarthritis (joint pain caused by cartilage degeneration)
- Soft tissue tumors
- Plantar warts (painful lesions on bottom of the foot caused by a virus)
- Plantar fasciitis/Heel Spur Syndrome
Neuromas/ Morton's neuroma (pain between 3rd and 4th metatarsals
that also cause burning, numbness and tingling)
There are plans to expand the use of this treatment modality to further increase the scope of foot problems that could be treated with the Cryostar. Cortisone injections, foot strappings, orthotics (arch supports), oral anti-inflammatories and surgery (plantar fasciotomy, shock wave therapy, heel spur resection, neuroma resection) may produce limited success in some patients.
Each insurance company has varying degrees of coverage. It is the patient's ultimate responsibility to check with the medical insurance carrier for specific coverage exclusions or limitations. For insurance plans that we do not participate with, payment will be expected on the day services are rendered.