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Doctor freezing nerves to ease pain

Dr. William Moore is treating patients with chronic nerve pain by using a freezing process. (PHOTO CREDIT: STONY BROOK MEDICINE)
Dr. William Moore is treating patients with chronic nerve pain by using a freezing process. (PHOTO CREDIT: STONY BROOK MEDICINE)

The pain resulting from neuralgia is often debilitating, but Dr. William Moore, a thoracic interventional radiologist at Stony Brook University School of Medicine, is implementing a new way to freeze parts of nerves to ease the pain.

Chronic nerve pain, or neuralgia, stems from damaged or destroyed nerves caused by surgery, trauma or disease. Patients experience extreme pain over an extended time period, reporting an average of eight out of ten on the pain scale, yet medicines and narcotics are often ineffective due to the differing pathophysiology of neuralgia.

Moore is implementing a new method, cryoneurolysis, to treat this pain. Using a probe inserted under the skin near the area of pain, Moore is able to access the nerves causing discomfort.

The probe contains two parts: a thin tiny tube with Argon gas and a large chamber surrounding the tube. Once the probe is in position, the tube is opened and the very rapid change in volume of Argon gas causes the temperature of the probe to drop to -180°C. Since tissue is composed mainly of water, the rapid temperature drop creates an ice ball that temporarily damages the outer covering and axon of the nerve. To optimize effectiveness, the probe is usually on for about three minutes.

According to Moore, after treatment, most patients report a drastic decrease in their pain from a level of nine out of 10 to zero out of 10.

While astounding, the effects of the treatment are not permanent. Due to regeneration of the outer layer of the nerve, pain usually returns within six months and the treatment procedure is then repeated.

While other treatment options such as radiofrequency oblation and the use of absolute alcohol are available, their variable effects and high risk factors make cryoneurolysis a highly sought-after option.

The side effects of cryoneurolysis are typically limited to numbness and pain during procedure, but bleeding and infection are possible, as with any invasive measure. Moore emphasized that cryoneurolysis is only for patients who have tried all other options and medications. He said, “The key is careful selection of patients who actually need it.”

For those who do need it, the pain relief offered by cryoneurolysis is life-changing. Moore recalled a patient who had damage to nerves in her head and could not put her head on a pillow for two years due to the pain.

After treatment, she was able to normally move her head and exclaimed “Oh my gosh, this is amazing!”

Moore also spoke about a patient who slept through the night for the first time in three years due to the pain relief caused by the treatment.

While Moore did not invent cryoneurolysis, according to him, he has the largest cohort of patients from across the U.S.

As of now, Moore said, “the generalizability of cryoneurolysis is limited, but it has potentially huge implications for millions as we learn more.”

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