Cryo Injection Therapy for Plantar Fasciitis

Cryo Injection Therapy Is A New Revolutionary Treatment For Plantar Fasciitis Symptoms. The Barn Clinic Is The First And Only Centre In The UK Offering Cryo Injection Therapy

Cryo Injection Therapy is also available for Morton’s Neuroma.

Cryo Injection Therapy for Plantar Fasciitis

Cryo Injection Therapy is a new minimally invasive procedure that can resolve or significantly improve symptoms.

Cryo injection therapy is the specialised field of using extremely low temperatures applied using a handheld probe to destroy pathological tissue.

This technique has been used for decades to treat malignant tumours of the prostate, liver and other organs. Cryo injection therapy is also gaining acceptance in dermatology, plastic surgery, urology and pain management. Now clinicians are using this technology to help manage common foot and ankle conditions.

Cryo injection therapy for plantar fasciitis has been performed since 2002 with excellent results. Generally most patients who have had this procedure have previously tried other treatments, including multiple steroid injections. Podiatrists in the United States report that approximately 90% of patients, after undergoing cryo injection therapy, had complete resolution of pain. The remainder had only minor residual pain that required no treatment (Dr. Lawrence Fallat DPM Chronic Plantar Fasciitis: Is Cryosurgery The Answer? Podiatry Today May 2005).

Are there any complications associated with Cryo Injection Therapy?

There have been very few reported complications with cryo injection therapy. Infection has been rare. The most common side effect has been the development of pain in another location of the heel or arch. This is the result of a post procedure compensatory gait and usually resolves in three to four weeks. Although early literature suggests that the analgesic relief with this procedure is temporary, a three-year follow-up of patients has revealed virtually no recurrences of the plantar fasciitis.

Understanding the scientific principles behind Cryo Injection Therapy

When cryo injection therapy is performed on peripheral nerves, the process is referred to as cryoneurolysis or cryogenic neuroablation. The nerve cells are destroyed as a result of the freezing process.

The cold causes destruction of the axon with breakdown of the myelin sheath and Wallerian degeneration. This breakdown of the axon is more complete with repeated freezing of the nerve followed by periods of thawing.

However the nerve is not totally destroyed leaving an intact epineurium and Perineurium. This permit ordered axonal regeneration and prevent the formation of amputation neuromas. Given that the axons can regenerate at the rate of 1 to 3mm per day, the analgesic or aesthetic effect of cryoneurolysis can be considered temporary. Cellular necrosis following cryoneurolysis results in the release of tissue proteins and this facilitates a change in protein antigenic properties. This could result in an autoimmune response specific to the cryolesion. This autoimmune response might explain the prolonged analgesic relief that lasts longer than the time required for regeneration of the axon. Other Podiatrists think that the cryo injection therapy simply acts as a 'reset' mechanism.

It is well known that people with plantar fasciitis do walk differently in an attempt to reduce pain; this is known as a compensatory gait or antalgic gait. However a persisting compensatory gait can actually contribute to the problem and prevent resolution. So in essence, the freezing and temporary blocking of the nerve that carries heel pain, allows a person to walk normally again, allowing the plantar fascia to recover.

Are there any complications associated with Cryo Injection Therapy?

There is a very low incidence of complications associated with cryo injection therapy. Infections are rare in the region of less than 1% as is abscess formation at the incision site. All patients who have had Cryogenic neuroablation have maintained full motor function with only a small loss of sensation around the area under the heel that is temporarily numb.

If patients are unlucky enough to experience a return of symptoms at the one or two year point the procedure can simply be repeated. Cryo injection therapy has been approved by the FDA, a branch of the United States government that regulates foods drugs and medial procedures and equipment. The Cryo injection therapy equipment at the Barn Clinic has also received a European Union ‘C.E’ mark for the treatment of neuroma and plantar fasciitis.

Can anyone have cryo injection therapy?

Obviously cryo involves very cold temperatures, therefore this procedure is not offered to those patients with poor circulation or peripheral vascular disease or conditions such as chilblains or Raynaud’s Phenomena or poorly controlled diabetes.

Costs

The costs of ongoing training, running and maintaining the equipment is high and provides little cost savings over conventional Plantar fasciitis surgery costs.

Is There A Waiting List?

We are the only centre in the UK offering cryo injection therapy and the current waiting list is 2-3 weeks. Please do not book a routine clinic appointment in the expectation that the procedure can be performed immediately on the day of the appointment.

If you are travelling from afar we are happy to offer advice on airport transfers from Manchester or Doncaster airports.