Focal spasticity of the foot and lower limb.
Image-guided interventions for focal foot and lower-limb spasticity: ultrasound-guided cryoneurolysis and targeted nerve blocks, delivered by an interventional radiologist.
Focal spasticity in the lower limb — whether post-stroke, post-traumatic brain injury, in multiple sclerosis, or from spinal cord injury — can severely limit function and footwear tolerance. Botulinum toxin is the most commonly offered intervention, but its effect is temporary and requires ongoing injections.
Cryoneurolysis offers a durable, non-pharmacological option. A small probe is advanced under ultrasound guidance to target the specific motor or mixed nerve driving the spastic pattern, and is cooled to approximately −88 °C. The axons are temporarily ablated; the outer nerve sheath is preserved, allowing eventual regrowth — so effect duration is typically measured in months, and the procedure can be repeated. Clinical evidence for cryoneurolysis in focal spasticity is emerging; see the published literature on PubMed. Individual results vary.
Who we treat
- Stroke and TBI survivors with residual foot or lower-limb spasticity.
- Patients seeking alternatives to repeated botulinum injections.
- Patients whose spasticity affects footwear, orthosis fit, or transfers.
- Rehab-referred patients as part of a broader spasticity programme.
How we work
- Diagnostic consult with Dr Lakkaraju (interventional radiologist) and James Ferrie (sonologist) as needed.
- Ultrasound mapping of the relevant motor branches.
- Diagnostic block under US guidance, to confirm expected functional benefit.
- Cryoneurolysis under US guidance if the diagnostic block predicts benefit.
Cryoneurolysis is delivered by Dr Amit Lakkaraju.
For referring rehabilitation physicians & neurologists
We welcome referrals from rehab consultants, neurologists and allied health. We are happy to receive a copy of prior toxin dosing, functional goals (GAS / Modified Ashworth), and any prior imaging.