Cryosurgery - Cryoanalgesia
Cryosurgery, sometimes referred to as cryotherapy or cryoanalgesia, is a surgical technique in which freezing is used to destroy undesirable tissues or anesthetize (numb) the affect area. Cryosurgery deals with temperatures below the freezing temperature of tissue, which is close to the freezing point of water. The history of cryosurgery is relatively short and is closely related with developments in low temperature physics, engineering, and instrumentation that were made during the last century. New instrumentation has been introduced and tested in the past several years that has proven efficacy in the treatment of several soft tissue conditions in the foot and ankle. These conditions include plantar fasciitis, plantar fibromas, neuromas and chronic pain associated with certain neuropathies.
Prior to the 1960's, the devices used for cryosurgery were not efficient and were able to freeze only to a depth of several millimeters. Therefore, freezing was used primarily for the treatment of skin lesions in the fields of dermatology and gynecology. Sense this time new instrumentation continues to be developed for the precise delivery of the treatment.
In cryosurgery the freezing probe is applied to a particular tissue site, and the area of freezing propagates outwards from the site of application into the tissue. Therefore, the extent of tissue affected by the treatment is greater than the tissue in contact with the probe. As such, cryosurgery is probably the first minimally invasive surgical techniques developed.
To apply cryosurgery precisely, it is imperative to know what are the mechanisms of tissue destruction during cryosurgery and how to evaluate the extent of tissue freezing and the thermal history in the frozen lesion. Advances in these areas have caused the recent resurgence in the field of cryosurgery.
Cryosurgery is an option for patients who have had less than desirable results from neuroma surgery and plantar fascia surgery. Cryosurgery has the advantage to traditional nerve surgeries because "stump neuromas" will not form following the procedure.
Cryosurgery/cryoanalgesia also has the advantages of high success rates, low complication rates and little down time. Generally a limited activity level for three days and reduction in exercise or prolonged walking and standing for up to three weeks is recommended. The time off work depends on the type of work performed. The procedure is performed in the office under a local anesthesia and generally takes 15 to 20 minutes.
One disadvantage is that cryosurgery is that it is often not a covered or only partially covered by many insurance plans. Cryosurgery is an excellent and safe option for relief of foot and ankle pain and is one more choice a patient has when considering treatment options.