Advice on Foot Care

Area of Heel Pain A new study suggests cryosurgery is an effective treatment option for chronic heel pain. Cryosurgery is a minimally invasive surgical technique involving the application of extremely low temperatures to lesions in an attempt to destroy abnormal tissues. In this study, the researchers evaluated 137 patients with chronic heel pain who underwent cryosurgery after failing 6 months of conservative care. The subject’s pain scores were measured prior to the procedure and at 3 weeks following the procedure and again at 24 months. Seventy-seven percent of patients reported successful pain relief at both 3 weeks and 2 years, while 23% failed to achieve pain relief. The authors concluded that cryosurgery was successful in both the short term and long treatment of chronic heel pain. An earlier study on 59 patients with plantar fasciitis who had failed conservative therapy and underwent cryosurgery, reported statistically significant improvement in pain scores up to a year following the procedure.

Cryosurgery has been used for decades to treat benign and malignant skin lesions along with numerous other conditions, including destruction of sensory nerves for pain relief. The use of cryosurgery as a treatment modality for heel pain is fairly new. The goal of the procedure is to destroy the nerves which supply sensation to the area of pain at the heel, a procedure called cryoneuroablation. Cryosurgery involves releasing gas into a chamber that results in a significant temperature drop. The temperature drop allows for the small tip of the probe to reach temperatures as low as – 70ºC. When the tip of the probe is applied to a nerve, the nerve cells are destroyed. Some feel this procedure is best used for those individuals who have entrapment of the medial calcaneal nerve, a condition that can occur in conjunction with plantar fasciitis or can be confused with plantar fasciitis.

Although cryosurgery may prove to be an effective treatment for chronic heel pain in a select group of patients, very little research has been done to establish it’s efficacy.

More on heel pain and plantar fasciitis.

Cavazos GJ et al. Cryosurgery for the treatment of heel pain. Foot Ankle Int. 2009 Jun;30(6):500-5.

Allen BH et al. Cryosurgery: an innovative technique for the treatment of plantar fasciitis. J Foot Ankle Surg. 2007 Mar-Apr;46(2):75-9.