Pain Management

Stopping Pain Cold | Migraines, Knee or Shoulder Pain

If you are experiencing knee pain and need to delay surgery or want to reduce pain after surgery, Myoscience’s iovera°® treatment may be an option for you! This treatment option is also now available for shoulder pain and migraines. 

This is a non-opiod option. Results can be felt immediately after the treatment.  Treatment for knee and shoulder pain and migraines.

Travis Tonniges, CRNA does the procedure and your PCP or specialty physician can order this procedure. 
Call to learn more about this procedure today at 402-443-1446.

Travis Tonniges, CRNA

Stop pain cold...with no opioids.

The mechanism of pain can be simplified as follows: sensory nerves transmit pain (sensory) signals from the affected region to the brain.  The brain then instructs that specific (affected) region in the body to alter its function to help mitigate the pain.  The body’s natural response to pain, especially musculoskeletal pain, disrupts physical function.  This pain affects and inhibit one’s normal daily activities.

Myoscience’s iovera°® technology disrupts the transmission of pain signals to the brain by taking advantage of the body’s natural response to cold.  This mechanism is referred to as cryoanalgesia (cryo = cold, analgesia = pain relief)

How does iovera° treatment work?

The ioverao treatment works by applying targeted cold to a peripheral nerve.  A precise cold zone is formed under the skin – cold enough to immediately prevent the nerve from sending pain signals without causing damage to surrounding structures.  The effect on the nerve is temporary, providing pain relief until the nerve regenerates and function is restored.

The ioverao treatment does not include injection of any substance- drugs, opioids or narcotics.  The effect of this treatment is immediate and can last up to 90 (ninety) days.  In one study, majority of the patients suffering from osteoarthritis of the knee have experienced pain and symptom relief beyond 150 days.*

How does it Compare to Other Modalities?

Drugs - NSAIDs and narcotics

Mild analgesics such as aspirin and ibuprofen (Non-Steroidal Anti-Inflammatory Drugs – NSAIDs) and more powerful ones like opioids and narcotics relieve pain but affect the entire body.  

A minimum of one dose per day may required for any of these drugs.  Continuous dosage may in turn have effects on other parts of the body.

iovera° treatment

The iovera° technology is used to treat specific nerves so the pain relief is focused only on the part of the body that is being treated.

One treatment with the iovera system can last 90 days.  Majority of patients have continued to experience relief beyond 150 days in clinical trial.*

*Radnovich, R. et al. “Cryoneurolysis to treat the pain and symptoms of knee osteoarthritis: a mulitcenter, randomized, double-blind, sham-controlled trial.” Osteoarthritis and Cartilage (2017) p1-10.

iovera Frequently Asked Questions

How does it work?
The iovera° treatment blocks targeted sensory

nerves from sending pain signals. A small probe (also

referred to as Smart Tip) is inserted into the treatment

region and a treatment cycle is performed. A precise

cold zone is formed under the skin - cold enough to

temporarily stop the nerve from signaling without

damaging surrounding tissue. This is repeated until the

nerve is blocked, providing pain relief until the nerve



Does the treatment hurt?
A local anesthetic will be administered to the area

before treatment. While the treatment should not be

painful, it is normal to experience pressure, a sensation

of cold, warmth, tingling and/or tapping during

treatment. This altered sensation during treatment is

an indication that the treatment is working.


Are there any side effects?
Common side effects include local pain, tenderness,

swelling, bruising and tingling or numbness. Typically,

these reactions resolve with no physician intervention.


How soon can I return to activity?
Post-treatment activity instructions are at the

discretion of your physician. You may return to

non-strenuous activity immediately after receiving the

iovera° treatment; however, your physician may have

additional instructions prior to your surgery. Consult

your physician regarding appropriate levels of activity.


How long do results last?

The treatment effect is immediate and lasts until the

nerve has fully regenerated. Treatment results may vary

by individual and the location of treatment. In general,

nerves regenerate at a rate of approximately 1mm per

day.3 In a randomized, multi-center study, 77% of iovera°

patients experienced a reduction in pain for up to

150 days.1


If my pain is blocked, why do I still need surgery?
The iovera° treatment effect is temporary. It does not

change the underlying condition for which your

physician has recommended surgery. However, iovera°

treatment prior to surgery can help improve pain scores,

function and overall symptoms.1,2,3


iovera brochures