Cryosurgery for Morton’s neuroma is a minimally invasive procedure in which an extremely cold probe, known as a cryoprobe, is used to selectively destroy tissue. Traditionally cryosurgery, or cryotherapy, has been used to treat a wide variety of cancerous and non-cancerous tumours. The Barn Clinic were among the first to use cryosurgery in the field of podiatry in the successful treatment of both Morton’s neuroma and a number of other painful foot conditions including plantar fasciitis, plantar fibroma and osteoarthritis of the ankle joint.
Unlike conventional Morton’s neuroma surgery cryosurgery can be performed in a clinic, and there is virtually no risk of the patient developing a stump neuroma following treatment. Cryotherapy also has a much shorter recovery period than other treatment options, and has an extremely high success rate.
Cryosurgery / Cryotherapy Explained
Cryosurgery uses Nitrous Oxide gas to form an 6-10mm ice ball at the tip of a cryoprobe, which reaches temperatures as low as -50°C. The tip can then be used to selectively destroy nerve tissue. In the case of Morton’s neuroma treatment this is done by causing extensive vascular damage to the nerve sheath capillaries. This then causes demyelination (breakdown of the myelin sheath) and degeneration of the axon. An important feature of cryosurgery treatment for Morton’s Neuroma to appreciate is that the essential aspects of the nerve, the epineurium and the perinerium, remain intact therefore preventing the possibility of formation of a stump neuroma on the foot which is a common occurrence with other surgical options.
Morton’s Neuroma Treatment
In cryosurgery for Morton’s neuroma the cryoprobe is used to disrupt the blood supply to the abnormal tissue, and ultimately to destroy the neuroma. The technique originates from the USA and is classified by American health insurance companies as an injection based technique. There are approximately 140 Podiatrists using cryosurgery for Morton’s neuroma, and over the last nine to ten years more than 50,000 cryosurgery procedures have been performed collectively. The success rates for these procedures are extremely high, ranging from 80-97%.
Cryotherapy does not completely destroy the nerve, and therefore does not usually result in permanent numbness of the foot or toes.
Cryosurgery for Morton’s Neuroma
Compared to conventional surgery, cryosurgery has a number of distinct advantages. For one the procedure does not need to be performed in a hospital, and hence is available at The Barn Clinic. This greatly reduces the overall treatment protocol and the amount of time required. As a clinical procedure cryosurgery does not require stitches, and is considerably less evasive than conventional Morton’s neuroma surgery. The recovery time is much shorter as a result, and there is very little post treatment neuroma pain and only mild bruising in the forefoot. This bruising only lasts 4-5 days; you can typically return to work after 24 hours and return to sport after just a few months. With cryosurgery there is no post-operative neuritis or neuralgia pain.
Cryosurgery patients are able to walk out of the clinic in their own shoes, and only require a plaster to cover the puncture site of their foot. Conventional Morton’s neuroma surgery necessitates that patients were a full post-operative boot, and will require post-treatment opiate based analgesics. This is not the case with cryotherapy.
Perhaps the greatest advantage of cryosurgery for Morton’s neuroma is the complete lack of stump neuroma formation risk in the foot. This is a common occurrence with convention surgery, and can be as painful as the original neuroma. Cryosurgery has a high success rate and wide patient acceptance.
The majority of Morton’s Neuroma patients obtain complete pain relief, or significant improvement, immediately following cryosurgery treatment. The cryosurgery denatures the nerve sheath (Morton’s neuroma are contained within the nerve sheath). Following cryosurgery the nerve regenerates at between 1-3 millimetres per day; therefore the axon regeneration should be complete within several weeks. It appears the long lasting pain relief is due to the reduction of neural oedema and nerve sheath fibrosis of the Morton’s Neuroma.
Similar long-term relief has also been reported with the use of cryosurgery in the treatment of painful trigeminal nerve pathology and plantar fasciitis.
Cryotherapy Treatment Complications
Cryosurgery has a very low incidence of complications associated with treatment. Infections are rare, as is abscess formation at the puncture site. All Morton’s Neuroma patients who have had cryogenic neuroablation (cryosurgery) have maintained full motor function with no greater loss of sensation than they had prior to the procedure. If patients are unlucky enough to experience a return of Morton’s Neuroma symptoms at the one or two year point, the cryosurgery procedure can simply be repeated.
Cryosurgery has been approved by the FDA, a branch of the United States government that regulates food, drugs and medical procedures and equipment. The cryosurgery equipment at The Barn Clinic has also received a European Union C.E. mark for the treatment of neuroma and Plantar Fasciitis.
Cryosurgery injection treatment involves very cold temperatures, therefore this procedure is not offered to those Morton’s Neuroma patients with poor circulation or peripheral vascular disease or conditions such as chilblains or Raynaud’s Phenomena.
Morton’s Neuroma Treatment with Cryotheraphy, UK
Cryosurgery for Morton’s Neuroma was introduced to the UK by Mr. Robin Weaver at The Barn Clinic. For many years Mr. Weaver had felt sympathy for those patients who had unsuccessfully tried all the existing remedies for their Morton’s Neuroma symptoms. Such patients were faced with the choice of either living with their foot pain or having standard surgery which could make matters worse.
Mr. Weaver felt that Morton’s Neuroma patients in the UK should have access to the alternative treatment of cryosurgery which is effective and safe. To this end, he completed his cryosurgical training in the US with one of the world’s most experienced cryosurgery trainers. On his return to the UK, Mr. Weaver has continued to work with American colleagues to develop and refine the technique further. Since introducing Podiatric cryosurgery into the UK in 2008, Mr. Weaver has now completed over 1000 cryosurgery treatments for both Morton’s Neuroma and Plantar Fasciitis and is pleased to have been able to help so many people with their foot pain and heel pain using this highly effective treatment.
The current waiting time for cryosurgery treatment at our clinic in Sheffield is 2-3 weeks. Please do not book a routine clinic appointment in the expectation that the procedure can be performed immediately. If you are travelling from afar we can offer advice on travel and help with airport transfers from Manchester or Doncaster airports.
With well over 5 years of Morton’s Neuroma cryosurgery behind us, and over 1000 cryosurgery treatments carried out at our UK clinics, we are now the most experienced Podiatric cryosurgery clinic outside of North America.