CryOzone Plus Procedure
The most advanced treatment and healing protocols developed by Dr. Marc Katz for heel pain and neuroma pain.
As technology improves and new treatments are available, outcomes can improve significantly. Below is the CryOzone Plus Procedure for neuroma and heel pain relief that has been developed by Dr. Katz and is currently being implemented by Dr. Brennan. It was developed by Dr. Katz based on years of experience as a pioneer in treating these conditions with the most advanced technologies and treatments available. Now with the benefit of having Dr. Katz for consulting and advising purposes Dr. Brennan will now be one of the few certified CryOzone Plus physicians in the country. This treatment replaces all previous treatment protocols that you may have seen in the past. The information noted below is very important and we do not make any exceptions to what is noted below. This will allow Advanced Podiatry to provide you with this unique successful treatment at a lower cost.
CryOzone Plus Procedure – Regenerative Neuroma and Heel Pain Cryo Treatment – A natural multi-modality approach for long-term relief
What Your CryOzone Plus 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 normal nerve growth
- Pneumodissection – Natural freeing of the nerve and scar tissue from surrounding tissue utilizing ozone gas. Allows for decompression of the nerve and protects surrounding tissue from cold temperatures without any cutting
- Prolozone – Regeneration and healing through use of high oxygen levels
- Prolotherapy –Regeneration and healing through natural substances.
- PRP– Regeneration and healing through use of platelets and growth factors.
Insurance Does Not Cover Any of the Procedure for Neuromas, Nerves 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.
- Advanced 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. This includes Cryo, Prolozone, Prolotherapy and ultrasound guidance.
- Initial consultation is $250. This does not apply to treatments costs.
- The cost for the procedure is $2500 per area, so, 2 neuroma areas would be $5000, 2 heels would be $5000.
- Repeat procedures are still the same amount.
As with any procedure, benefits and risks will be discussed with you in detail and there are no guarantees provided. Greater than 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. Brennan 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 travelled from afar at your expense also does not change this decision. Dr. Brennan will only do what they deem as medically appropriate. Dr. Brennan and Advanced Podiatry are not responsible for any of your expenses for any reason.
Out of State Patients- Important Information
Advanced 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. It is possible that you may travel to have the procedure and not be a candidate. Advanced Podiatry cannot make any guarantees and will not be responsible for any of your expenses. (Please see hotel list below)
All out of state patients must arrive to have initial consultation prior to procedure. If it is determined that you are a candidate the procedure will be scheduled within the week.
Following the procedure, a mandatory follow is needed at three working days post procedure. Please make travel plans to accommodate this.
Phone consultations are not possible for this type of procedure.
Please see common questions for out of state patients under FAQ
Tampa Cryosurgery Common Questions
Advanced Podiatry answers questions regarding CryOzone Plus on a daily basis. They have compiled the most common questions and answers to help you be a well informed patient and to understand the details of the procedure.
More questions will be added on a regular basis. If you have questions that are not answered here, please send them to us and we will add them. We would like this to be as comprehensive as possible.
QUESTION: Should I travel to come see Dr. Brennan for CryOzone Plus Treatments?
ANSWER: Many people come with a diagnosis that may or may not be correct. This could result in a patient not being the best candidate for the CryOzone plus procedure. So, if you are traveling please realize that there is no way for Dr. Brennan to make a diagnosis from an email or phone call and that this can only be done when you come to the office. Before traveling, you must weigh your options and understand the uncertainty that may be present with regard to your diagnosis and treatment. Most patients that travel end up with good results.
QUESTION: Should I travel to come see you if I have neuropathy?
ANSWER: We do not recommend travel for neuropathy. You should be near the office. Neuropathy treatment is complex and requires multiple visits and treatments assuming you are a candidate. However, Dr. Brennan do provide superior treatments for neuropathy.
QUESTION: Why didn’t I get relief from the procedure?
ANSWER: With any procedure, there is no guarantee that you will get relief. Dr. Brennan perform this procedure to give each patient the greatest chance of getting 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.
QUESTION: What happens to the nerve after it is frozen?
ANSWER: The nerve is injured but not destroyed and the body will regenerate a new normal nerve.
QUESTION: Will I have immediate relief after the procedure?
ANSWER: No, not usually. It takes time for the nerve to regenerate and also time for the surgical area to heal. It takes time for the fascia 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.
QUESTION: Will I need more than one procedure?
ANSWER: 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.
QUESTION: Can this treatment cause permanent nerve damage?
ANSWER: 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. However, in most cases there is significant relief.
QUESTION: If I have relief how long will it last?
ANSWER: 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. Brennan will recommend custom orthotic devices to maintain your foot structure and prevent recurrence.
QUESTION: Do all people get relief after the treatment?
ANSWER: No, as with any procedure you may not get relief and may require additional procedures. However, the CryOzone plus procedure is certainly superior to the traditional surgeries and should be tried before consideration of more invasive procedures.
QUESTION: How long will I be sore after the procedure?
ANSWER: That will vary with each patient, however some people experience inflammation and soreness for up to 4-6 weeks.
QUESTION: I’ve had alcohol injections for my neuroma. Does that change the success of the procedure?
ANSWER: Yes it does. If you have had alcohol injections, the nerve itself changes and becomes more resistant to treatments. However, with the CryOzone plus procedure the success rate is almost as high as those that have not had alcohol injections.
QUESTION: Does travel have any effect on my healing?
ANSWER: 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.
QUESTION: Is it possible to have more pain after the procedure?
ANSWER: 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. However, it is important to note that the standard surgical procedures have more complications and a greater chance of problems and worsening symptoms compared to CryOzone plus procedure.
QUESTION: I’ve been to many doctors and have had virtually all treatments available. I’ve read about your treatment and it sounds like a miracle!
ANSWER: The CryOzone plus procedure is a wonderful successful treatment for many painful foot and ankle conditions. It is often superior to other treatments including the conventional surgeries. However, no medical treatments can be miracles. There are no medical treatments or procedures that work for all people. So, please keep in mind that this is a treatment that is not fail-proof. You must approach the procedure with reasonable expectations. Any physician claiming a guaranteed result 100% of the time, is not being honest with you.
QUESTION: How does your cryosurgery procedure differ from other cryosurgeons?
ANSWER: CryOzone plus is superior and uses direct ultrasound guidance and Regenerative Medicine Techniques. The procedure is not performed blindly as often performed by other doctors. With the newer protocol, there are very few other physicians performing a similar procedure. The CryOzone plus procedure uses CryoMax which is a much more precise procedure done with the aid of an ultrahigh resolution magnifying digital ultrasound capable of Doppler visualization of blood vessels. The nerves are identified in close proximity to the vessels. When CryoMax is performed, the Cryosurgeon is looking directly at the structures that he is freezing and can actually measure the area of nerve tissue that is frozen. There is little doubt what is being frozen and whether the probe is in the correct area. Without Doppler Ultrasound, the procedure is done blindly. The percentage of success is much higher with color ultrasound guidance than without it. The general public needs to understand that because of the cost of proper training, equipment and market pressures, many doctors perform the procedure blindly and have had little to no training.
To date, Dr. Brennan is one of only a few doctors using the CryOzone plus procedure in the United States. If you are going to have the procedure done, wouldn’t you prefer to have it done correctly to maximize the pain relief? In addition the whole protocol is rapidly evolving and the newest changes have added Regenerative Medicine techniques to enhance the procedure.
QUESTION: Can I do both feet at the same time?
ANSWER: It depends on which areas are being treated and how many nerves are involved? Typically, Dr. Brennan will treat two nerves at a time or two heels at a time.
QUESTION: Is it possible that I will travel from out of town and I will not be a candidate for the procedure?
ANSWER: 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. Brennan will only perform the procedure on conditions that they feel will benefit from the protocol. However, please note that Dr. Brennan can modify the approach and perform some of the Regenerative Medicine techniques to still provide significant relief.
QUESTION: Will I have numbness in the foot that will affect my walking?
ANSWER: 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.
QUESTION: Why aren’t more podiatrists performing this procedure?
ANSWER: Many podiatrists are not interested in new technology and are not willing to invest time and money in advanced training. Dr. Brennan pride themselves on bringing the latest technology to their patients. The CryOzone Plus Procedure has a fairly large learning curve and the equipment to perform the procedure is expensive. Dr. Brennan have ongoing training with Dr. Katz who had training in Regenerative Medicine and has been using these techniques for over 10 years.
QUESTION: Does having this procedure preclude having regular surgery at some future date if it were deemed necessary?
ANSWER: 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.
QUESTION: What about having a second procedure if the first doesn’t do the job?
ANSWER: A second procedure is sometimes needed and can be done without problems; however the time between procedures is likely several months.
QUESTION: What are the risks associated with the procedures?
ANSWER: 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. 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.
QUESTION: If I have had this pain for 2 years, can this procedure still help me? I was told some treatments might not help because of the length of time I have waited to do anything.
ANSWER: Many of the people I treat have had their pain and problem for years. This treatment is excellent regardless of the time that you have had the problem. In resistant cases, you may need more than one treatment.
QUESTION: I have a neuroma. If the neuroma increases in size, how do you know if it’s too big for the cryosurgery to work?
ANSWER: The neuroma can only grow so large and can be frozen at the thinner portion of the nerve behind the enlargement. Also, it is possible to treat several areas of a nerve or heel. The addition of regenerative techniques also helps overcome this problem.
QUESTION: What is the difference between surgery to cut the plantar fascia and cryosurgery?
ANSWER: 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. This is considered a more involved foot surgery. So if it was my foot that would absolutely be my last option. With 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. As a colleague of mine once suggested, it is rebooting the nerve, just like a computer reboot. Also there would be super freezing which removes swelling and promotes the healing cascade.
QUESTION: Can my problem that is treated with CryOzone Plus recur after the treatment?
ANSWER: 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.
QUESTION: I am coming from out of town. Realistically, how quick can I travel home.
ANSWER: See the protocol above for the suggested time frames.
QUESTION: Where is the procedure performed.
ANSWER: The procedure is performed in the office using a local anesthetic. There is no need to use a surgery center or hospital. This is one way that the treatment is much more affordable than other treatments.
QUESTION: Can this procedure permanently damage the nerve?
ANSWER: 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.
QUESTION: I was a patient for cryosurgery a few months ago. In general I am very pleased with the surgery. There were two neuromas present. The “toggling” effect, which was very disturbing and debilitating is gone. And the “electrical shock” inside my foot is gone. Inside that same toe however there still seems to be a bit of a problem. Do you think that it is something I should just accept or do you think you want to go in and do more freezing? There is the electric shock effect and a burning along the bottom of that toe.
ANSWER: Glad to hear that you have had significant relief. The pain in the toe is sometimes caused by a small nerve branch that goes into the toe. I’ve had similar situation where I will go back in and freeze the area with success. I typically advise waiting around 3-4 months from the first cryosurgery procedure before considering this type of repeat because it usually will resolve.
QUESTION: Will I need pain medication after the procedure?
ANSWER: 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.
QUESTION: Do I have to pay full price again if I need the procedure repeated?
ANSWER: Yes. A repeat procedure still takes the same amount of time and requires the same skill level.
QUESTION: I have arthritis, does this affect the likelihood of success of the cryosurgery?
ANSWER: No, we use the CryOzone plus procedure to treat people for pain associated with arthritis
QUESTION: How many patients need to have cryosurgery a second time?
ANSWER: We are unable to predict this possibility. Each person’s body is different. Some patients have had alcohol injections and other treatments that make the nerve more resistant to the freeze. Some people have had heel surgery. Some patients have even had the traditional nerve surgery prior to having the CryOzone plus procedure. So, as you can see, we have to evaluate each person individually.
QUESTION: How soon after the procedure do you know it’s a success?
ANSWER: 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.
QUESTION: 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?
ANSWER: 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.
QUESTION: I am coming from out of town. I am wondering if I can know before I return home if the procedure worked.
ANSWER: Not necessarily. You may be sore from the procedure and it would be hard to tell until healing is complete.
QUESTION: My insurance will not cover this procedure. What is the cost of consultation? Are there any other costs? What is the total cost of cryosurgery?
ANSWER: The CryOzone plus procedure is not covered by any insurance. This is a cash procedure. The initial consult is $250 and the procedure itself is $2500 per location.
QUESTION: Do you offer payment plans?
ANSWER: 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.
QUESTION: What else is needed to make an appointment?
ANSWER: Speak with the office for help with all details.
QUESTION: Right after the cryosurgery, what are my limitations regarding walking, swimming, etc.?
ANSWER: 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 if often present and will increase with too much activity. Some people will need to wear a healing boot.
QUESTION: Would you be able to give me some references of patients who have had this procedure done?
ANSWER: I am not able to do this because of strict privacy laws and time constraints. Also cryosurgery is individualized for each patient. Each patient has different pain and has had different treatments. So, outcomes will be different for each patient.
QUESTION: If I still have pain after the procedure, what are my options?
ANSWER: Dr. Brennan will possibly start some simple treatments to get you through the temporary pain. Typically, Dr. Brennan will have you wait several 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.
QUESTION: If I have the cryosurgery, do you think I will be able to return to my regular exercise?
ANSWER: 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.
QUESTION: How many have been pain free after the procedure and for how many was the surgery unsuccessful or the pain got worse?
ANSWER: There is no accurate way to calculate a percentage success rate. It is rare not to have some relief and even more rare that the problem would worsen. We frequently get referrals from patients that have had the procedure and have had continued relief. We can tell you that this procedure is far superior to having the nerve removed and there is no chance of stump neuroma (a complication of nerve removal). It is also superior to heel surgery. It would be extremely rare to get worse. So this is likely your best option. It would not be unusual to be pain-free for years.
QUESTION: Are you aware of anyone in my city who is experienced with cryosurgery?
ANSWER: We can only recommend other cryosurgeons that we personally know.
QUESTION: Will the procedure hurt?
ANSWER: Dr. Brennan 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. This avoids the need for the use of techniques that are more painful. The technique was developed to allow the patients to have the procedure done with minimal discomfort.
QUESTION: Where do you perform the procedure?
ANSWER: 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.
Hotels for Out of State Patients
(we have no financial interest in any hotels listed)
1207 S Howard Ave
Tampa, Fl 33606
|Hyde Park Hotel
2105 W Bristol Ave
Tampa, Fl 33606
| Best Western Tampa
734 S Dale Mabry Hwy
Tampa, Fl 33609
| Quality Inn Airport
1020 S Dale Mabry Hwy
Tampa, Fl 33629
| Renaissance Tampa
4200 Jim Walter Blvd
Tampa, Fl 33607