Cryoneurolysis for painful spasticity

What is cryoneurolysis?

Cryoneurolysis is an innovative, minimally invasive treatment performed in-office that uses controlled cold to temporarily turn off overactive nerves. The procedure uses a small probe and precise ultrasound and nerve stimulation guidance to target the nerves to help relax tight muscles and reduce pain caused by spasticity. With this procedure, no medication is injected into the body, and symptom relief can last 6 months to 2 years.

What conditions can cryoneurolysis treat? 

Cryoneurolysis may help adults with painful spasticity caused by: 

• Stroke
• Brain injury (traumatic or anoxic)
• Cerebral palsy
• Multiple sclerosis
• Spinal cord injury

Who is a candidate for cryoneurolysis?

You may be a good fit for cryoneurolysis if you: 

• Are 18 and older.
• Have painful muscle tightness (spasticity).
• Can lie on an exam table for about 90 minutes with minimal movement. Some shifting can be done every 10-15 minutes if needed. 
  

This treatment may not help if your joint cannot move at all due to severe stiffness (joint contracture with no range of motion). 

How can it help me?

Cryoneurolysis can make daily life easier. It may help you: 

• Feel less muscle tightness and stiffness. 
• Have less pain. 
• Move more easily. 
• Do everyday tasks like dressing and bathing with less help. 
• Rely less on medications. 

How is cryoneurolysis different from other spasticity treatments?

• Botulinum toxin (Botox) injections: treats the muscle, uses medication, can help loosen muscles and sometimes reduce pain, more risks and side effects.
• Phenol injections: Targets the nerve, uses medication, mostly reduces muscle tightness, more risks and side effects.
• Cryoneurolysis: Targets the nerve, does not use injected medicine (just controlled cold), reduces tightness and pain, less risks and side effects.

Patients can still receive Botox injections for spasticity while getting cryoneurolysis. This combination treatment can be helpful for patients who've reached the maximum safe dose of botulinum toxin and still have areas of muscle tightness.

Why choose us for cryoneurolysis? 

WashU Medicine Orthopedics has the only neurorehabilitation practice in Missouri offering this innovative treatment for painful spasticity.

What does the procedure involve? 

Evaluation 

Before you can be scheduled for the procedure, you'll first meet with a provider for an evaluation. Your provider will review your symptoms and examine your muscle tightness and movement, making sure this treatment is right for you. If your provider thinks it's a good fit, you'll be scheduled for the cryoneurolysis procedure. 

Procedure

The entire procedure is performed in-office, and lasts about 90 minutes. You will lie very still, but will be able to shift positions every 10-15 minutes if needed. Your provider will use a small probe, ultrasound and gentle electrical stimulation to identify the right nerve. Each nerve is treated with 2-4 short freezing cycles, each cycle lasting less than 2 minutes.

Follow-up care

• You will be seen back in our office 2-6 weeks after the procedure to review your results.
• Your second follow-up appointment will take place 6-10 months after the procedure. During this visit, your provider will check to see if symptoms are returning and discuss next steps and whether a repeat treatment could help you continue to feel your best.

Will insurance pay for cryoneurolysis? 

Cryoneurolysis is covered by insurance for painful spasticity only. A referral is required.