Advanced Minimally Invasive Cryosurgery
Regenerative Neuroma and Heel Pain Treatment, a natural multi-modality approach for long-term relief!
Disclaimer: Before reading the following about cryosurgery, please understand that no service is guaranteed until my personal in office clinical evaluation is done. No matter the distance you travel there is a chance that you may not receive cryosurgery on your visit. This is strictly done to ensure the patient receives the best and most precise treatment possible. If applicable other treatments may be offered during consultation.
The most advanced natural, minimally invasive treatment for heel pain and neuroma pain. At Healthy Feet Podiatry, Dr. Todd Brennan is now one of the few physicians in the country that performs Nervana Cryosurgery. The information noted below is very important and we do not make any exceptions to what is noted below. This will allow Dr. Todd at Healthy Feet Podiatry to provide you with this unique successful treatment at a lower cost.
What your Nervana Treatment Includes:
- CryoMax – Procedure for healthy nerve and heel tissue regeneration. Natural nerve and heel treatment, under ultrasound guidance, followed by regenerative medicine techniques for healing and new nerve growth.
- PRP (Platelet Rich Plasma) – Regeneration and healing through use of platelets and growth factors.
Insurance Does Not Cover Any of the Procedure for Neuromas or Heels:
- Your insurance does not cover any of these procedures regardless of what they may tell you.
- There are no insurance codes for your procedures.
- Healthy Feet Podiatry will not submit claims to any insurances under any circumstances.
- We will not speak to your insurance company on the phone and will not be involved in any written correspondence with your insurance company.
- We can happily provide you with a narrative of the procedure that you may use to send to your insurance company.
- Treatments for neuromas and heel pain are purely cash procedures paid fully at the time of the service.
- The cost for the procedure is $2500 per area, so, two neuromas/heel areas would be $5000.
As with any procedure, benefits and risks will be discussed with you in detail and there are no guarantees provided. Greater than 80-85% of those having the procedure will have complete or significant long-term relief. Less than 10% of patients will require a repeat procedure.
It is possible that at the time of visit, Dr. Todd may not agree with your current diagnosis and may feel that you are not a candidate for the procedure. Previous diagnoses from other physicians do not change this decision. The fact that you have traveled from afar at your expense also does not change this decision. Dr. Todd will only do what he deems medically appropriate for you as the patient.
Out of State Patients- Important Information
Healthy Feet Podiatry must confirm that you are a candidate for the procedure. We no longer rely on the diagnosis of other physicians or the results of prior tests, however both are reviewed. It is possible that you may travel to have the procedure and not be a candidate. Healthy Feet Podiatry can not make any guarantees and will not be responsible for any of your expenses.
All out of state patients must arrive to have an initial consultation prior to procedure. If it is determined that you are a candidate for the procedure, it will most likely be done that day.
Nervana Cryosurgery procedures are done on Monday mornings, with follow ups scheduled for Wednesday. All out of state/country patient’s must plan accordingly.
*** Phone consultations are not possible, a clinical consultation must be performed, at which point all previous documentation/imaging will be reviewed. ***
Cryosurgery Common Questions
The most common questions and answers to help you be a well-informed patient and to understand the details of the procedure are below.
Should I travel to come see Healthy Feet Podiatry for Nervana Cryosurgery?
Many people arrive with a diagnosis that may or may not be correct. This could result in a patient not being the best candidate for the Nervana Cryosurgery procedure. So, if you are traveling please realize that there is no way for Dr. Todd to make a firm diagnosis from an email or phone call and that this can only be done when you arrive to the office. Dr. Todd can review previous medical notes and discuss other treatments during the in office consultation. Before traveling, you must weigh your options and understand the uncertainty that may be present with regard to your diagnosis and treatment.
Should I travel to come see you if I have neuropathy?
We do not recommend Nervana cryosurgery for neuropathy.
Why didn’t I get relief from the procedure?
With any procedure, there is no guarantee that you will get relief. We still believe that this treatment option should be considered before more invasive procedures. However, they make it clear that this cannot be guaranteed.
What happens to the nerve after it is frozen?
The nerve is injured but not destroyed and the body will regenerate a new normal nerve.
Will I have immediate relief after the procedure?
No, not usually. It takes time for the nerve to regenerate and also time for the surgical area to heal. It takes time to heal and allow all of the treatments to start the natural healing response from your body. So, don’t expect to be pain-free immediately. In some cases people require weeks to months to heal and need time to assess their total amount of relief.
Will I need more than one procedure?
Depending on your condition and previous treatments, you may require several procedures, however, this is rare. If the pain returns you may also need another round of treatment. However, this is more desirable than the traditional procedure.
Can this treatment cause permanent nerve damage?
Since we are causing injury to the nerve, permanent nerve damage is possible. It is possible to get more prolonged damage that may result in continued pain. That is a risk that you take with any surgery. This is the case with any type of nerve surgery including the traditional nerve removal procedures and heel cutting procedures which have a higher complication rate.
If I have relief how long will it last?
That will vary with each patient. Since the nerve regenerates, pain can return after a number of months or years especially if the same damaging forces are still present. However, in most case the nerve will regenerate with minimal inflammation and there will be significant prolonged relief. This is also the case for heel pain and the fascia can become inflamed again. This is why Dr. Todd recommends custom orthotics to maintain your foot structure and prevent recurrence.
Do all people get relief after the treatment?
No, as with any procedure you may not get relief and may require additional procedures. Overall, there is an 80-85% success rate.
How long will I be sore after the procedure?
That will vary with each patient, however some people experience inflammation and soreness for up to 4-6 weeks.
Does travel have any effect on my healing?
Yes, we have found that many people that travel experience more swelling and soreness for a number of weeks following the procedure. So healing time is prolonged. This likely occurs from internal swelling while in flight. This is much less common with procedures done locally without flying. If you are coming from out of state this may delay overall healing time, but not prevent healing.
Is it possible to have more pain after the procedure?
Since this is a surgical procedure, it is possible to have increased pain and soreness from the procedure. In some rare cases patients have reported that their pain actually worsened. In those cases we continue treatments to resolve the pain. So, we are unable to guarantee that you will get relief and not have increased pain.
Can I do both feet at the same time?
It depends on which areas are being treated and how many nerves are involved? Typically, Dr. Todd will treat up to two nerves or both heels at a time.
Is it possible that I will travel from out of town and I will not be a candidate for the procedure?
Yes that is possible. Some patients come in with complex problems that may not benefit from the procedure or may have an incorrect diagnosis from another doctor. So before traveling to Tampa, please realize that possibility. Dr. Todd will only perform the procedure on conditions that he feels will benefit from the protocol.
Will I have numbness in the foot that will affect my walking?
Some patients may have areas of numbness. However, it depends on the area being treated. Even if there is numbness, patients prefer that over pain. The numbness would be a small area and does not cause walking problems. The nerves being treated only provide sensation and have no control over the muscles or joints of the foot or ankle.
Does having this procedure preclude having regular surgery at some future date if it were deemed necessary?
No, this is not an issue at all. There will be nothing removed surgically from your foot. You can have any other procedures in the future.
What are the risks associated with the procedures?
They are the same as any surgery but since this procedure is minimally invasive, complications are rare especially when compared to the traditional surgeries for heel pain and neuroma excisions. Infection, abscess and worsening pain are a few possibilities. However, again these would be extremely rare. Numbness may be a common side effect but is not considered a complication.
What is the difference between surgery to cut the plantar fascia and Nervana Cryosurgery?
The procedures are very different and unrelated. When the fascia is released, you are cutting a portion of the plantar fascia, which is a support structure for the foot. With Nervana Cryosurgery and Regenerative Medicine, the treatment will allow the body to naturally begin healing while providing relief from destruction of smaller nerves near the fascia. The theory is that when the heel is inflamed, the nerve gets trapped and damaged. Also, there is a pain signal to the spinal cord that is disrupted after the freezing. Also there would be super freezing which removes swelling and promotes the healing cascade.
Can my problem that is treated with Nervana Cryosurgery recur after the treatment?
Yes, It could return no matter what type of procedure or treatment you have, even with a major surgery. The procedure is a highly successful, minimally-invasive procedure with excellent results. If necessary it can be repeated. In addition, we always recommend wearing orthotic arch supports for the future to prevent recurrence by correcting the foot structure and decreasing the stress on the foot that caused the original problem.
I am coming from out of town. Realistically, how quick can I travel home.
The procedure will be performed on Monday mornings with the follow up on Wednesdays. Flying soon after the procedure could cause increased swelling and delayed healing. Telehealth follow up calls are something that we do after the first follow up.
Can this procedure permanently damage the nerve?
In most cases, the nerve will regrow into a more functional normal nerve. This is typically what the body will do. However, it is possible to have permanent damage but this will usually have no adverse effects with respect to walking and activities. You could have an area of numbness.
Will I need pain medication after the procedure?
Most patients use over-the-counter medicine such as Tylenol. However, rarely, we may use a mild pain medication. We do not recommend anti-inflammatory medicine as we want good inflammation in the area to promote healing.
Do I have to pay full price again if I need the procedure repeated?
Yes. A repeat procedure still takes the same amount of time and requires the same skill level.
How soon after the procedure do you know it’s a success?
It could be days, several weeks or several months, again each person is different. Your pain relief results from an extensive healing and regeneration process. Since we are all different the process can start quickly or may be prolonged. This is the reason for such a large range of possibilities.
If I choose to do this, I will try to combine it with a vacation, since I don’t live in Tampa. Would I need to be off my feet afterwards?
You would need to take it easy for the first few weeks, that’s the average, some more and some less. We don’t recommend going to Disney, etc. and walking around excessively.
I am coming from out of town. I am wondering if I can know before I return home if the procedure worked.
Not necessarily. You may be sore from the procedure and it would be hard to tell until healing is complete.
My insurance will not cover this procedure. Are there any other costs? What is the total cost of Nervana Cryosurgery?
Nervana Cryosurgery is not covered by any insurance. This is a cash procedure. The procedure itself is $2500 per location, this includes the procedure and all follow ups.
Do you offer payment plans?
We do not offer payment plans for this procedure. In order to keep the procedure at a reasonable cost we must be paid in full at the time of the procedure.
What else is needed to make an appointment?
Right after the Nervana Cryosurgery, what are my limitations regarding walking, swimming, etc.?
You will need to limit major activity for at least 48 hours. However, some patients take longer to heal, since each person is different. Swimming is allowed when the small skin opening closes. Soaking is not permitted until the opening is fully closed. Soreness is often present and will increase with too much activity. All patients wear a walking boot afterwards for two weeks.
Would you be able to give me some references of patients who have had this procedure done?
We are not able to do this because of strict privacy laws and time constraints, however see the patient testimonial. Keep in mind, Nervana Cryosurgery is individualized for each patient. Each patient has different pain and has had different treatments. So, outcomes will be different for each patient.
If I still have pain after the procedure, what are my options?
Typically, we will have you wait at least three months before evaluating success. If you have had no relief or minimal relief the procedure can safely be repeated or you can opt for traditional surgery.
If I have the cryosurgery, do you think I will be able to return to my regular exercise?
Most patients return to normal activity and that is the goal, however there is no way to predict or guarantee who may or may not be able to return to all activities. There are so many variables involved.
Will the procedure hurt?
We will use local anesthetic to numb your foot. This will be the only part that may cause discomfort. With an advanced technique using the color power Doppler, we are able to locate the freezing spot.
Where do you perform the procedure?
The procedure is done in the office and takes 30 minutes or less. This allows the cost of the procedure to be significantly lower and affordable when compared to procedures done in surgery centers. This is one important benefit of cryosurgery.