CRYO SURGERY

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Cryoanalgesia has been known to decrease pain and inflammation for centuries. Physicians, physical therapists and sports trainers have relied on ice therapy to address many musculoskeletal conditions and injuries in particular, during the early inflammatory phase. Not only do lowered temperatures result in vasoconstriction of blood vessels, thus reducing inflammation, but also create an anesthetic effect by altering nerve function.

Historically, researchers performing cryosurgery observed that extreme freezing had an anesthetic effect beyond the temporary relief produced by simple cooling. Over the last thirty years, many modalities have been introduced to address chronic pain by surgeons, pain management specialists, and neurosurgeons. These techniques have had a common goal of producing prolonged nerve blocks to relieve intractable pain. Within the last ten years, cryosurgery has been utilized to relieve trigeminal nerve pain, lumbosacral pain and most recently carpal tunnel syndrome.

It is with great excitement that in late 2003 through 2003, the vision and work of Lawrence M. Fallat, DPM, FACFAS demonstrated that cryosurgery may have a place in podiatric medicine to treat several foot and ankle conditions. Early studies indicate cryosurgery to be a safe and effective modality in treating foot neuromas, plantar fasciitis (heel pain/heel spur syndrome) and recalcitrant nerve pain.

PRINCIPLES OF CRYO ANALGESIA

Cryosurgery is a treatment modality that utilizes controlled cooling to destroy pathological tissues. Cooling is accomplished via the expansion of highly pressurized and compressed gas (nitrous oxide) through a cryoprobe. Cryoneurolysis involves the destruction of the pathological nerve cell by freezing intracellular elements leading to cell death. The surrounding soft tissue (epineurium, perineurium) of the nerve fiber remains intact allowing for subsequent nerve regeneration. This differentiates cryolesions from other neurolytic lesions that destroy the surrounding soft tissue that ultimately may result in neuroma formation.

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