The most common cause of deep pain on the bottom surface of the heel is Plantar Fasciitis – inflammation of the plantar ligament or fascia.
The plantar fascia is a broad band of fibrous tissue that normally measuring 3mm-3.8 mm in thickness which runs along the bottom surface of the foot, from the heel to the toes. It is just below the skin and subcutaneous fat and helps to secure the long arch of the foot.
Injury or mechanical foot problems can trigger a chronic inflammatory process which causes a thickening of the plantar fascia. In Severe cases, the plantar fascia can enlarge by three to four times its normal thickness causing compression of nerves and pain.
The application of extreme cold to inflamed tissues has been performed since the earliest of times. Hippocrates also is known as the father of modern medicine was probably the first to report such benefits over two thousand years ago.
Cryosurgery utilises a cryo-needle that is carefully guided to the source of the heel pain. When in place, the cryo-needle is rapidly cooled down to minus 50 centigrade. This rapid cooling of the inflamed tissues very quickly reduces pain and inflammation within the heel.
Modern cryosurgery for heel pain is a highly effective and safe treatment that treats the source of the pain and inflammation. It even has a rejuvenating effect on the plantar fascia, because the freezing stimulates collagen production in the plantar fascia and it is thought that the cryosurgery helps reverse angiogenesis –the process where abnormal blood vessels form in the plantar fascia caused by chronic inflammation.
Cryosurgery is the only treatment that addresses the other common problem chronic heel pain sufferers face- painful swollen enlarged nerves in the heel. Imaging of chronic heel pain suffers often reveal abnormally enlarged nerves, following cryosurgery these sore enlarged and inflamed nerves quickly calm down and shrink back to normal size.
The benefit of treatment is seen typically within two to three days – where pain levels will have for most patients, almost disappeared. Ultrasound imaging of heels six weeks after cryosurgery shows that the thickening and inflammation of the Plantar Fascia will be at least 50% better. At three months after cryosurgery, approximately 85% of patients are totally pain-free. Ultrasound Imaging of those patient’s heels performed three months after cryosurgery shows that the inflammation and thickening of the plantar fascia have totally disappeared.
Cryosurgery can literally be a ‘quick-fix’ and long-term cure. This is illustrated by a study of 137 feet (1), the mean age was 56 years old and the mean BMI was 33. All patients had unsuccessfully tried the type of measures chronic heel pain suffers commonly try. These measures included stretching, icing, arch supports and custom orthotics and physiotherapy, and steroid injections. The patients in this study graded their pain on a scale of 0-10. 0 being no pain and 10 being the most severe pain ever experienced in their life. The mean pain score prior to treatment was 7.6 (minimum sore 6 maximum score 9) The patients in the group had a high BMI so were overweight, middle-aged with coexisting health problems that included diabetes and osteoarthritis. As you can see the patients in this study were not ‘easy patients’ to treat, quite the opposite.
By only 3 weeks after cryosurgery, 77.4% obtained pain relief with the mean pain score decreasing to 1.6 these results were sustained, and at 24 months the mean score was 1.1. Interestingly the treatment was given ‘blind’ without ultrasound guidance. Even without guidance, there were no complications recorded. Modern cryosurgery is always now performed with ultrasound guidance, improving the results of an already effective and safe technique.
These days we also see the pain relief for our patients kicking in a lot sooner than three weeks, more commonly within three days.
(1) Cavazos et. al. [ Cryosurgery for the Treatment of Heel Pain]. Foot Ankle International 2009.Vol 30. No 6
Your treatment will take place in a bright, clean and airy treatment room, and will be carried out by Mr Robin 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 1 in 100 patients report feeling a cold sensation during a small portion of the treatment.
The treatment is performed as an ultrasound guided injection technique.
The full length of the treatment will typically last around 40 – 60 minutes, including administering anaesthetic and dressing the area after.
You can walk immediately after treatment and you will not require crutches.
3 days. Unless you have an automatic car and it’s your left heel that has been treated, in which case you can drive straight away.
Typically 3 days if you are work in a non-manual job and two weeks if you have a manual job.
Yes. The vast majority of our patients travel quite a way to visit the clinic. For this reason, we are happy to offer consultation and treatment on the same day. Your consultation will take place in the morning, and your treatment in the afternoon. We do require you to leave the premises for a few hours to comply with informed consent regulations and to consider all the information provided to you during your consultation. In order to arrange a same-day consultation and treatment, we do require a deposit to secure your appointments. Mr. Weaver specialises in Cryosurgery for Plantar Fasciitis and Morton’s Neuroma, and therefore Cryosurgery is available Tuesday – Friday (inclusive). Both your consultation and treatment will take place at the same location.
Consultation (including ultrasound imaging) – £250.00
Treatment (per foot) – £1,650.00
The Barn Clinic was the first Clinic in the UK to offer Cryosurgery for both plantar fasciitis and Morton’s neuroma.
Complications from cryosurgery for both plantar fasciitis and Morton’s neuroma are extremely rare and occur in less than 1% of cases.
We have been performing cryosurgery since 2009.