Orthopedic Surgeon Discusses iovera Cold Therapy For Pain Relief from Knee Osteoarthritis

PainRelief.com: Would you explain what is meant by cryoanalgesia?

Response: Cold has been used to relieve pain for hundreds of years and modern cold therapy, or cryotherapy, is a trusted technique for treating pain. Cryoanalgesia, a type of cryotherapy, applies intensely focused cold therapy to a specific nerve to prevent its ability to transmit a pain signal to the brain.

The iovera° system has simplified the delivery of cryoanalgesia. Many traditional cryotherapy treatments were invasive and used large complicated machines. With the iovera° handheld device, clinicians are able to deliver precise, controlled doses of cold temperature only to the targeted nerve.

PainRelief.com: For whom is the procedure indicated or helpful? 

Response: iovera° provides pain relief for patients dealing with chronic osteoarthritis pain and/or surgical pain from knee replacement surgeries. The treatment can be used for patients dealing with various stages of OA pain, including those who may not be candidates for surgery, patients looking to delay surgery, or as a pre-habilitation approach to surgery. For patients undergoing total knee replacement surgery, iovera° can be used in combination with other non-opioid options to reduce postsurgical pain while minimizing or, in some cases, eliminating the need for opioids. For this reason, it can be especially helpful for patients who are hoping to stay away from opioid pain medication and the unwanted side effects that may come with taking prescription opioids.

PainRelief.com: Is there a risk of long-term nerve damage or other complications?

Response: The iovera° treatment is safe and does not damage or destroy any surrounding tissue. As the iovera° treatment blocks targeted sensory nerves from sending pain signals, a precise cold zone is formed under the skin—cold enough to temporarily stop the nerve from signaling without damaging surrounding tissue. This cycle is repeated until the nerve is blocked, providing pain relief until the nerve regenerates. iovera° produces only a 2nd degree nerve injury, meaning that the effects are temporary and fully reversable.

Additionally, the iovera° treatment is a focused therapy. Because of this, there are no side effects to the entire body and nothing is injected into the treatment area by the iovera° system. Therefore, very few, if any, localized side effects or complications due to the iovera° treatment have been observed and side effects are mild. I encourage all patients to consult with their physician to determine if cryoanalgesia with the iovera° system will benefit them.

PainRelief.com: What else should readers take away from your report?

Response: As physicians, I believe we all have a responsibility to work toward reducing opioid exposure for our patients due to the risks and side effects associated with these medications. In my practice, I utilize iovera° two weeks prior to patients’ total knee replacement procedures in addition to other non-opioid options during surgery. Through this protocol, I have personally seen that patients feel more confident about pain management throughout the surgical process, as they are able to experience firsthand the immediate effect of the iovera° treatment before surgery. In fact, most patients share that they feel empowered knowing that they won’t need opioids to manage pain after surgery due to my non-opioid multimodal pain management approach.

Any disclosures?

Dr McMillan is a consultant for Pacira BioSciences, Inc.

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