Cryosurgery for Neuromas
Surgery can work wonders, but by nature it’s invasive. Whether cutting or scraping tissue away, or suturing it back together, surgery is literally carefully controlled damage. No matter how effective surgery might be, it should always be considered an option of last resort. It’s a matter of common sense to consider less invasive treatments first.
It unfortunately, is common for patients with painful yet non-life-threatening conditions to get caught in a limbo of sorts—less invasive methods don’t provide complete or lasting relief, yet they’re reluctant to undergo surgery. For several common (and very painful) foot conditions, cryotherapy fills this middle ground perfectly.
Patients with neuromas and plantar fibromas are ideal candidates for cryotherapy: they’re very common, not life threatening and are often extremely painful. Patients with these growths often report 8 or 9/10 pain when walking or even standing upright. More importantly, cryotherapy has a proven track record of possibly providing substantial relief without surgery—something that was impossible prior to FDA approval of cryotherapy for these conditions in 2003.
Cryotherapy refers to selectively destroying unwanted tissue (such as neuromas and fibromas) using extreme cold. A successful procedure, cryotherapeutic, starts with an exact diagnosis. While these two conditions account for the majority of painful, benign foot masses, it’s essential for a professional to eliminate all doubt. Once the diagnosis has been confirmed by your podiatrist, the treatment area is numbed with local anesthetic such as lidocaine. A small incision is made, and cryoprobe is inserted. The cryoprobe itself is a marvel of medical engineering—it’s a thin, gas-cooled tube that produces an “ice ball” at its tip that reaches temperatures as low as -70C.
These extremely low temperatures accomplish two specific goals. Such extreme cold kills much of the unwanted tissue outright, with very little unwanted damage to surrounding healthy tissue. In the case of plantar fibromas this is essential, since further damage or scarring of the plantar fascia can cause the formation of more fibromas.
Cryotherapy also has the ability to desensitize the chronically irritated nerves surrounding these growths. This has the effect of toning down pain coming from the affected area, while not interfering with normal sensation or muscle function. This is especially beneficial for neuromas, which actually occur inside the small nerves at the base of the toes.
If you’ve got the severe pain associated with neuromas or plantar fibromas, you know it. The good news is that now there’s a minimally-invasive option that’s highly effective—and often permanent.
Call us at 878-313-FEET (3338) for a consultation with a board-certified podiatrist for Cryosurgery Pittsburgh.
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- Monday – Friday 8:00 am – 5:30 pm
- Evenings and weekend available for emergencies
- 22 years of experience
- 4 convenient locations
- Board Certified Podiatrist ABFAS
- Customized treatment plan
- Confidential private settings
- Pittsburgh’s locally and family owned
- Minimally invasive and non-invasive options
- Comfortable atmosphere
- Medically trained staff
- On-site physician
- Free parking
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Frequently Asked Questions – Cryotherapy
What are the risks of cryotherapy in Cranberry?
- Cryotherapy in Cranberry is often a safe and great alternative to invasive surgery. In most cases, there are less risks or complications following cryosurgery than open surgery. However, there is the risk of mild infection (often able to be cleared on its’ own without treatment), scarring (mostly seen in patients who normally scar easily), and in very rare cases, mild sensory damage to the foot at the site of the neuroma. For any concerns, please contact our office at 878-313-FEET (3338) to speak with any of our medically trained staff!
How exactly does cryosurgery work for Morton’s neuromas?
- Dr. Teimouri has performed cryosurgery in Pittsburgh on hundreds of patients, and has explained the technique many times. The word “cryo” means “cold.” In cryosurgery, a specialized probe called a cryoprobe is used to generate extremely cold temperatures—about -70 degrees Celsius. This creates a small “ice ball” inside the neuroma, destroying the nerves that cause pain. The small blood vessels supplying circulation to the nerves are frozen, which immediately causes them to stop transmitting pain and stops the neuroma from growing. One of the primary benefits of cryosurgery is that it only destroys the nerves inside the neuroma, so it doesn’t affect the patient’s ability to feel their feet. As a side-note, cryosurgery has a great track record: over 50,000 cryosurgery procedures have been performed by podiatric surgeons in the last decade.
What if steroid (cortisone) injections have failed? Can cryosurgery help?
- In Bridgewater podiatrist Dr. Teimouri commonly uses cryo on failed cortisone patients. It is important to note that long-term cortisone use can weaken the surrounding tissue to the point where more injections are no longer indicated. A single injection usually doesn’t present a problem.
How long does cryosurgery take?
- Cryotherapy in Beaver is a time efficient procedure, typically lasting less than an 1/2 hour. The majority of the hour is dedicated to ensuring that you are completely numb prior to the procedure. The cryosurgery procedure itself takes less than 10 minutes.
Is cryotherapy for the treatment of a Morton’s neuroma painful?
- Cryotherapy for Morton’s neuroma in Pittsburgh is not painful! A local anesthetic numbing medication is administered before the procedure by our Pittsburgh podiatrist, to ensure that you do not experience any pain or discomfort. The numbing medication is given through injection, but is not typically injected into the area of the neuroma. Dr. will inject through the top of the foot where the skin is not as sensitive.
Why do some patients take a longer or shorter time to recover?
- After hundreds of cryo procedures, leading podiatrist near Ross Township expects different patients to respond differently to any procedure. Patients with a lower pain tolerance often feel that they take longer to become pain free. In particular, some patients with hypermobility syndromes (“double jointed”) may take longer to heal from surgery.
Can I drive after having cryotherapy for a fibroma in Wexford?
- It is best that you have someone drive you home following cryosurgery in Wexford, as your foot will still be numb for several hours. Our Dr. recommends that for the next 24 hours you limit your activity, elevating your foot as often as possible and only walking short distances, no longer than 10 minutes at a time.
Can I continue to play sports or exercise after having cryosurgery?
- Yes, but not immediately. Vigorous activities, such as running or playing your favorite sport, should be avoided for up to two weeks. While less time may be required, we recommend consulting with our podiatrist in Moon Twp. as healing time is individualized per patient.
Is cryotherapy covered by insurance in Pittsburgh?
- Cryotherapy in Pittsburgh may be covered, depending on your insurance plan. For plans that do not cover cryotherapy, we offer affordable pricing options. For eligibility and pricing, please contact our office at 878-313-FEET (3338).
Why isn’t the use of cryosurgery in Pittsburgh more common?
- Put simply, the equipment is expensive and requires extensive training to use correctly. Cryotherapy has a steep learning curve. We’re extremely proud that Beaver Valley Foot Clinic is one of the few offices that offer cryotherapy treatments. Our Coraopolis podiatrist Dr. Teimouri has successfully performed hundreds of cryosurgery procedures on hundreds of satisfied patients.
Do all podiatrists who offer cryosurgery have the same qualifications?
- No. It is generally advised that only a podiatric surgeon perform cryosurgery. Again, all cryo procedures performed at the Beaver Valley Foot Clinic are performed by Dr. Teimouri, a board certified podiatric surgeon. Any podiatrist is technically qualified to perform in-office cryosurgery, but our Cranberry podiatrist has additional credentials and hundreds of hours of experience.
Is cryosurgery a good option to consider before more invasive surgery?
- Absolutely. Less invasive options should always be tried before more invasive ones. Seven Fields podiatrist Dr. Tina Teimouri firmly believes that cryosurgery regularly saves people from traditional open surgery. Other Pittsburgh foot doctors will use cortisone and other minimally invasive treatments, but can’t offer cryosurgery as an option.
What does cryosurgery cost?
- Some of our Foot Clinic patients find that cryosurgery is covered by their insurance, so only their deductible and co-pays would be a consideration. Many do not. Call our offices for insurance eligibility and full pricing details.
Should I keep taking my medications as usual before my cryosurgery? If not, which medications might need stopped?
- Most drugs don’t interfere or complicate cryosurgery at all. There are a few exceptions though. Below is a list of medications which could potentially interfere with a cryo procedure. As always, it is extremely important that patients consult with the doctor who prescribed the medication before stopping it. This is extremely important and cannot be over-emphasized.
- This is a common anti-platelet medication often given for various heart, artery, and vein conditions. In nearly all cases this drug should be stopped for 10 days pre-procedure. Again, don’t discontinue any drugs without the advice of a doctor.
- This common over-the-counter NSAID (non-steroidal anti-inflammatory drug) is often used as a blood thinner for daily use. While risks are extremely small, aspirin is still a blood thinner. We recommend that all cryosurgery patients discontinue aspirin for one week pre-procedure.
- This potent blood thinner should be stopped prior to cryosurgery (or almost any other surgical procedure). This is especially important if you’re taking a high enough dosage to raise your INR above a value of 2. Almost all doctors prefer an INR level between 1.0 to 1.5 before proceeding with any procedure. Since warfarin is an essential medication, patients preparing for cryotherapy should convert to a low-molecular-weight heparin for several days beforehand.
- This is commonly prescribed for the management of rheumatoid arthritis and many other chronic inflammatory forms of arthritis. Most rheumatologists agree that methotrexate can be taken as normal before, during, and after cryosurgery. A few doctors have a different opinion, so it’s important to check with yours, but this drug is generally considered safe for cryosurgery patients.
What is the healing time following cryotherapy?
- While different for each person, the maximum benefit of cryotherapy in Sewickley is often seen after about 3 months. However, as previously stated, this is an average and varies depending on you and the level of discomfort you experienced following cryosurgery.
What are some advantages of cryosurgery? How is it superior to regular surgery?
- It’s effective. The procedure has a high success rates.
- It’s much, much less invasive than traditional “open” surgery (where large incisions are made in the skin).
- It’s virtually painless.
- It’s an inpatient procedure, no hospital stay is needed. No general anesthesia is needed (being “put under.”
- It’s quick: the entire procedure takes about an hour.
- It’s has a much shorter recovery time. Patients can resume normal activities in about 5 days.
- It’s a good option when other surgeries or cortisone injections have failed.
- It’s got a very low risk of major complications (such as formation of a stump neuroma).
- It’s even got an extremely low risk of minor complications such as postoperative pain and inflammation. Any that occurs is almost always minimal.
- It’s got a great track record for safety. Unlike most other foot surgeries, cryo treatment preserves sensation in the foot. Cases of unintentional nerve damage are almost non-existent.
- It’s available right here in the Greater Pittsburgh Region. Cryosurgery in Hopewell, Ross Township, Butler, and the North and South Hills is available only from Beaver Valley Foot Clinic.
What are some contraindications against having Morton’s neuroma cryosurgery treatments?
- Our Mars podiatrist, Dr. Teimouri, feels that cryosurgery is safe for the vast majority of her patients. Some possible exceptions include:
- Advanced Peripheral Artery Disease (PAD). In these individuals, circulation to the feet is already compromised. PAD is a condition likely to complicate any surgery.
- Raynaud’s Syndrome: the feet of these patients are already cold sensitive. It’s unlikely that cryosurgery will make Raynaud’s worse, but it has happened in rare cases.
- Patients with pre-existing damage to nerves in the feet.
Is cryosurgery the only Morton’s neuroma treatment that your clinic offers?
- No. Beaver Valley foot Clinic offers many treatments, ranging from least invasive to most invasive. These treatments range from prescribing NSAIDS, orthotics, arch supports, injections… to cryosurgery …to full “open” surgery. We offer more solutions than the vast majority of podiatrists in Pennsylvania.