Cryo for Ledderhose in the UK

I have long been seeking a definitive answer as to whether the procedure to freeze a plantar fibroma nodule (aka cryotherapy or cryosurgery) is available in the UK. Last week I received an e-mail from a clinic which performs the procedure, therefore answering my question; yes cryo is available in the UK.

They have not been performing it long but I have opened a line of communication with them and they seem happy to answer my questions. I have asked them a few questions which I am waiting to hear back about.

However I was sent an information leaflet which gave me some more details which I have outlined below:

• The total time required is around 40 minutes
• The treatment should not occur within 6 weeks of having a steroid injection (an alternative treatment for Ledderhose)
• The total cost of treatment is around £1400 for a single fibroma, including consultation, £2000 for 2 fibroma's when they are treated at the same time. 
• A local anaesthetic is first applied to the target area
• A probe, cooled to -55 Celsius is then guided using ultrasound to the target. In total the area will be cooled for 6 minutes which is broken down into 2 lots of 3 minutes.
• A steroid will then be applied to the area to reduce inflammation.
• The goal is to cause shrinkage in the fibroma and a decrease in pain.
• “If your condition was caused by certain repetitive foot movements such as running or dancing then there is a risk the condition may return if the foot is exposed to these factors.”
• The treatment may not work and the condition could still develop and more fibromas could appear. In the leaflet it states that the worst case scenario is the surgical removal of the entire plantar fascia. The article does not however cover that you may wish to try radiotherapy. I am currently researching to find out whether the 2 can be performed one after the other.
• The leaflet also states that the condition may increase in soreness for 3-4 weeks before then seeing a steady decrease in pain for around 6 weeks and will ideally see complete pain relief by weeks 12-14.

I am unable to see any statistics on how frequently the treatment works or how long it is expected to last for, also questions I have asked.

Stay tuned to updates to this post and hopefully more information becoming available for Cryo in the UK. If you are a UK patient and you have had this treatment then please let me know as I would really like to speak to some patients who have had Cryo. 

LD, DD and knuckle pad patient using Verapamil gel - Petricd

Right so everyone it is time for another patient interview again I have contacted this person using the Dupuytren's online forum. I contacted this person because they have been using verapamil gel. For those who don't know what this is I recommend you visit the PDlabs website but it is a gel that you apply to the the disease areas and it helps to stop progression and maybe reduce nodules. I may do a treatments post on this to explain further but from the PDlabs website HERE it says that it is a calcium channel blocker and calcium is required for the production of collagen. 

Anyway thanks to Patricd for agreeing to do this and providing the answers below. 

1) Do you have Ledderhose Disease, Dupuytren’s disease or both? 


I have both Ledderhose and Dupuytren's as well as knuckle pads to boot!

2) Do you have a family history of the disease? If yes how prevalent is it? 


Yes my father, and his brother have it in their palms but no contracture, just lots of webbing and cording.

3) How long have you been symptomatic? 


I have been symptomatic for 1 1/2 years.

4) What treatments have you received? 


I have just had transdermal verapamil gel as I do not yet have a contracture of the fingers (but a cord can be felt).

5) How successful were these treatments? 


The Verapamil lotion eliminated the night pain in my feet and softened the tumors in my feet. Can't say it did much to the knuckel pads or the cords in my palms.

6) You said you had verapamil treatment, what was this experience like? 


It is just a case of applying the gel and costs $69 per 1 1/2 month supply made by a compounding pharmacy at 10% concentration cream.

7) Are you currently satisfied with the treatment that you have received?


Yes it has worked better on my feet than hands. No other treatment is available except Xiaflex but it is not FDA approved for knuckle pads or plantar fibromitosis. 


Summary: 


So as you can see the results for this are average. I have not seen any data that suggests that this works properly and in fact if you look on the Dupuytren's Society page it is shown as only have anecdotal evidence for it. Clearly the person above has had good results on their feet and the prices that they have it for are not too bad compared to some of the other more proven options. 


As I said I hope to do a treatments page on this and see what evidence I can find for it working and maybe seen if I can find the exact science behind why it works. Hope you enjoyed the interview and thanks again to Patricd.