Cryosurgery is a modern form of treatment for Morton’s Neuroma, which offers patients a minimally invasive, clinic-based procedure with a high success rate and no risk of stump neuroma.
In Morton’s neuroma, fibrous tissue develops around the nerve, which becomes irritated and compressed. This causes severe pain on the ball of the foot and at the base of the toes. The amount of pain experienced can range from a slight tingling sensation to an intense burning sensation which stops sufferers from being able to go about their daily lives. Morton’s neuroma can occur on one foot or both feet and though it is rare, some patients can develop more than one neuroma in the same foot.
A Morton's neuroma is a thickening in the sheath tissue of the nerve, and in most cases the neuroma will occur between the 3rd and 4th toes. And less commonly, between the 2nd and 3rd toes.
Morton’s neuroma can affect anyone of any age, however it is most common in females, aged between 30–60. We have found that while around 75% of our patients are female and generally middle-aged, it is not at all uncommon to see neuromas in men and young adults, particularly if they have an active hobby or career.
"I cannot express how grateful I am that you were able to sort out my neuroma. I tell lots of people about your clinic and how my life has changed"
Cryosurgery for Morton's NeuromaCryosurgery is the use of extreme cold in medicine or surgery to destroy abnormal or diseased tissue. The term comes from the Greek words cryo (“icy cold”) and surgery meaning “hand work” or “handiwork”. Cryosurgery has been historically used to treat a number of diseases and disorders, especially a variety of benign and malignant skin conditions. Cryosurgery uses Nitrous Oxide gas to form a 6-10mm ice ball at the tip of a cryo-needle, 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.
Stages of Cryosurgery
1. Application of
2. Temporary degeneration
of the axon and
myelin sheath of the nerve.
3. Regeneration of the
axon & sheath at a
rate of 1-2 mm per day
Wiping the Slate Clean
We like to think of Cryosurgery as wiping the slate clean, and returning your nerve to how it was before the neuroma occured. Due to the accuracy and precision used during the Cryosurgery treatment, we are able to selectively target and cause the breakdown of the thickened neuroma tissue, leaving the affected nerve unharmed and undamaged. The subsequent tissue breakdown and reabsorption, will leave you with an intact, healthy, fully-functioning nerve. Just how it was before the neuroma developed.
A Clinic-Based Day Case Procedure
Cryosurgery is carried out in clinic, rather than a hospital, as a day case procedure, with no need at all for lengthy or overnight stays. This means you can be flexible when booking your appointment on a date and time to suit you.
A Minimally Invasive Option
Cryosurgery is a minimally invasive procedure, and performed with minimal disruption to the anatomy of your foot. The keyhole procedure is carried out through a tiny puncture site, with constant Ultrasound image guidance. Cryosurgery removes the need for open surgery, large incisions and scarring.
No Risk of Stump Neuroma
A huge area of concern for Morton's Neuroma sufferers facing excision surgery / neurectomy is the risk of stump neuroma formation. Unlike the conventional Morton’s neuroma excision surgery, with cryosurgery there is virtually no risk of the patient developing a stump neuroma following treatment, as we are not cutting or severing the affected nerve. We are simply freezing the neuroma tissue.
With Cryosurgery for Morton's Neuroma, the essential aspects of the nerve, the epineurium and the perinerium, remain intact, and therefore ultimately preventing the possibility of formation of a stump neuroma in the foot.
Cryosurgery does not cut, destroy or kill the nerve, and therefore does not usually result in permanent numbness of the foot or toes.
No Stitches, Sutures, or Crutches.
The minimally invasive nature of the procedure means that there is no need for any stitches or suture to close any wounds or incision sites. Instead, and simple paper stitch is applied, followed by a small dressing.
This means patients aren't required to wear any surgical boots or use crutches, and that you aren't required to return to clinic to have any stitches removed.
Minimal Downtime & Post Treatment Recovery
With Cryosurgery, the immediate recovery time is just 3 days. During the 3 days post treatment, we advise patients to limited their weight-bearing to approximately 5-10 minutes per hour, and the spend the remainder of the initial days off their feet.
Patients are then able to return to their activities of day-to-day living, such as work and driving, after just 3 days post treatment.
Performed under Local Anaesthetic
Due to the minimally invasive nature of the cryosurgery procedure, it is not necessary to administer a general anaesthetic. We only anaesthetise the interspace/area in which we are going to be treating, meaning you will still have full sensation in the rest of the foot. This is particularly beneficial to patients, as it means they are able to walk out of the clinic following the procedure with no need for crutches or a wheelchair, and you wont be left with any grogginess or side effect from general anesthetic.
We use 2 different types of anesthetic for the cryosurgery treatment. We initially administer a ‘fast-acting’ local anesthetic, which will numb the area within 1-2 minutes and will generally last around 1 hour. We also administer a ‘long-acting’ local anaesthetic, which will take around 5 -10 minutes to take effect, but will last on average 6-20 hours, making sure you're comfortable into the evening.
"Needless to say I am so very grateful to you Robin for perfecting this technique and offering such a fabulous alternative to conventional surgery. Although I am proud to have worked for the NHS for nearly 39 years, I will not hesitate to recommend The Barn Clinic to anyone suffering from the same complaint as myself.
Your service excels and I feel that it really would be foolish for someone not to at least consider this as an option.
Finally please convey my thanks to Georgia and Danielle who are warm, friendly and very professional young ladies. They made me feel at ease from the moment I arrived. I'm used to dealing with patients but not being one - they made a difference. Delighted, delighted, delighted!"
Excellent Success Rates & Patient Satisfaction
Cryosurgery for Morton's Neuroma has excellent success rates and patient satisfaction rates. For more information on the success rates of Cryosurgery for Morton's Neuroma, please get in touch or request and information pack.
A Single Treatment
With Cryosurgery, the treatment is provided and single, one-off treatment rather than a course of multiple treatments. For patients, this means they are often able to schedule treatment sooner, and at a time to suit them, without having to commit to lengthy repeat visits.
Cryosurgery has a very low incidence of complications associated with treatment. Infections are incredibly rare, as is abscess formation at the puncture site. As a clinic, we place an incredibly high importance on infection control, which is reflected by our incredibly low infection rates.
All Morton’s neuroma patients who have had 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.
There have been multiple studies conducted concerned with the efficacy of cryosurgery for Morton’s neuroma. We have a bank of studies on file, which you are welcome to request.
The No.1 Treatment for Athletes, Dancers & Skiers
Athletes, skiers and dancers have a high risk of developing Morton's Neuroma. For athletes in particular, cryosurgery is the most popular treatment option - primarily because of the quicker recovery period it offers over conventional Morton's neuroma surgery.
At The Barn Clinic we have many years’ experience of dealing with acute sports injuries and conditions such as Morton’s Neuroma. We have worked with Professional Footballers, EIS Athletes, Professional Dancers, PGA Golfers, Wimbledon Tennis Champions and International Rugby Players. We are always happy to liaise with club doctors and physiotherapists, and where necessary provide detailed biomechanical assessment and neuroma specific sports friendly orthotics.
Explosive ‘stop start’ multi-directional movement can cause sports people such as dancers and footballers to be especially prone to forefoot problems such as Morton’s Neuroma. The forces involved in such activities can cause a separate precipitating condition called synovitis or capsulitis of the metatarsal phalangeal joints in the forefoot. Synovitis is essentially a swelling of the joint’s outer lining.
The inflammation of the synovitis can impinge and chaff the inter-digital nerve as it passes by, ultimately causing a neuroma. Such sports people therefore require careful management because if the underlying biomechanical issue that caused the synovitisis not dealt with the neuroma can return after treatment.
One of the main benefits of cryosurgery for professional athletes is the dramatic reduction in downtime after treatment. Often, professionals can be back in training with little or no pain after just a few weeks.
Cryosurgery at The Barn Clinic, Sheffield & London
Mr. Robin J Weaver at The Barn Clinic, was the first clinician in Europe to use Cryosurgery for Morton's Neuroma, as well as for the treatment of Plantar Fasciitis. Furthermore we are now the first clinic worldwide to successfully treat stump neuroma with cryosurgery. We are frequently asked to lecture and provide cryosurgery training and advice and share protocols with other podiatrists, doctors and clinics.
Your treatment will take place in on of our clinic procedure rooms, and will be carried out by Mr Robin J Weaver, with assistance from another member of staff. Both Robin and his assistant will ensure you feel at ease during your appointment and will often chat to you throughout the treatment.
You will be sat up (or laid back on request) in your own clothes, and you are welcome to bring a family member into the treatment with you.
As with many minor procedure in which anesthetic is require, the first numbing injections are the most uncomfortable part of the treatment, but following these injections you wont feel any pain or discomfort. Some patients report feeling slight vibration from the probe, approximately 100 patients report feeling a cold sensation during a small portion of the treatment.
The full length of the treatment will typically last around 40 – 60 minutes, including administering anaesthetic and dressing the area after.