Important things to remember when you attend your first appointment

Always bring the shoes that most aggravate your pain. This is very important, as the clinic sometimes performs diagnostic injections – these are only helpful if you have shoes that rapidly bring on your symptoms.

Insoles and Pads

Always bring insoles and pads that have been made or bought to treat your neuroma. We will not perform cryosurgery on a patient who has not tried some form of conservative care such as insoles, pads or footwear change.

Scans or Medical Reports

Always bring your scans or medical reports if you have these, especially if you hope to have treatment on the day of your consultation. Ideally, send them to us before you attend.


Do not drive to the centre for your initial appointment. You may require a diagnostic injection, in which case you will not be able to safely drive home. However, you can usually drive if your left foot is affected and you have an automatic car. Please note that after cryosurgery, patients must rest on the back seat of the car with their foot elevated, and they cannot drive or use public transport.

Before your appointment

We will send you a comprehensive information pack, which provides information on podiatric surgery, including training and qualifications. It is important that you read this as it also covers the possible risks associated with surgery.

Before your appointment, we will ask you to sign and send us a form, which confirms that you have read the relevant information leaflets about cryosurgery. Where possible, we prefer not to treat patients on the day of their consultation. We do appreciate, however, that some patients have a long way to travel. We may therefore be able to perform the procedure on the day if you fulfil the necessary criteria.

Whether we proceed with an operation is entirely up to the discretion of Mr McCulloch. Key factors that would steer this decision include:

Confirmation that your symptoms are indeed consistent with an interdigital neuroma. If you are travelling far, then it is obviously in your interest to make sure you have the correct diagnosis. Ideally, you should have an MRI or ultrasound scan report from a consultant radiologist. In some instances, Mr McCulloch may not agree with the diagnosis that you have been given by another practitioner. Sometimes, more than one neuroma may be present, in which case a diagnostic injection can help with the diagnosis. We can often do this during the consultation, and in some instances a positive response may then allow for cryosurgery to take place. In some cases, patients have more than one condition, where foot instability has led to neuroma symptoms alongside other pathologies. In these cases, cryosurgery may not be the best treatment option, or if performed, we will carefully counsel the patient on the fact that some symptoms from other causes may remain.


Confirmation that conservative care has been tried. All patients must have tried conservative care for a reasonable period – this largely consists of insoles, orthoses and footwear change. We will not necessarily expect you to have tried a steroid injection.


Patients with a more complex medical history may require more extensive medical preparation prior to cryosurgery. If they are under another consultant, such as a neurologist, rheumatologist or pain specialist, Mr McCulloch will often wish to liaise with these specialists before proceeding with cryosurgery. However, we will often treat higher-risk patients, as they may be far more suited to minimally-invasive cryosurgery than open surgery.