Iovera

What is iovera®?

Percutaneous cryoneurolysis using iovera® is a short outpatient, minimally invasive procedure that temporarily disrupts the function of sensory nerves carrying pain signals from a painful area such as the knee. It does not require general anesthesia or incisions. It provides long-term pain relief for many patients suffering from certain types of joint or nerve pain. It has most commonly been used prior to knee replacement surgery to reduce postoperative pain and the need for opioid pain relievers for up to three months. It can also be used to treat knee pain caused by osteoarthritis, shoulder pain and nerve pain caused by intercostal neuralgia.

The doctors at Pain Management Specialists are trained and experienced in the use of mild® Procedure for patients with lumbar spinal stenosis.

Am I a candidate for iovera®?

Your board-certified pain management physician at Pain Management Specialists determines if you’re a candidate for iovera® after an evaluation. You should not have iovera® if you have cryoglobulinemia, paroxysmal cold hemoglobinuria, cold urticaria, Raynaud’s disease, and open and/or infected wounds at or near the treatment site

Anyone planning on having knee replacement surgery in the near future is a candidate for iovera®. The procedure is typically performed at least two weeks prior to surgery. In addition, those with painful, arthritic knees are candidates for iovera® if they respond to a diagnostic procedure called genicular nerve block.

What happens during the iovera® procedure?

Your Pain Management Specialists doctor may use iovera® in the office or outpatient surgery center with local anesthesia. The procedure typically takes 20 to 40 minutes, depending on how many nerves are being treated.

After identifying the nerves to be treated using ultrasound and numbing the skin, your doctor directs a long needle-like probe towards the nerve. After precisely positioning the probe next to the nerve, nitrous oxide at high pressure is passed through the inner channel of the probe and expands at the tip, where it freezes the nerve to -88℃ for about two minutes. The gas does not enter your body, but is exhausted from the iovera® device. Once complete, the probe is removed and a sterile bandage is applied. Multiple nerves are usually treated in one treatment session.

Since the iovera® procedure is done without anything more than local anesthesia, you do not need to have someone drive you home. You will be asked to make a follow up appointment with Pain Management Specialists in about a month.

The minimally invasive iovera® procedure has a safety profile similar to nerve blocks but with lasting results, and patients typically return to normal activity within 24 hours with no restrictions. Common side effects include numbness, which is to be expected, bruising and temporarily increased pain. Infection, bleeding and permanent nerve injury are rare (less than 1:1000). Some potential complications unique to iovera® include cold injury (frostbite) to the skin, particularly when superficial nerves are treated, changes in skin pigment and skin dimpling.

iovera® is covered nationwide by Medicare part B. Medicare Advantage and commercial coverage varies.

When will I feel pain relief after the iovera® procedure?

Pain relief after iovera® procedure is usually immediate, though there may be a short period of nerve irritation for up to two weeks.  Studies have shown that the relief is durable for at least 3 months.

The Pain Management Specialists team has witnessed remarkable advances in the treatment of pain in the last few years and has been on the forefront of offering the latest proven treatments to patients. They are among very few interventional pain management practices in the area trained to evaluate and treat patients with the iovera® procedure. To learn more about the iovera® procedure and how it may alleviate your pain, call Pain Management Specialists or book an appointment online today.