iovera° Treatment for Knee Pain in Northern Virginia
Targeted cryoneurolysis using controlled cold to temporarily reduce pain signals from selected peripheral nerves in patients with knee osteoarthritis and certain patients undergoing knee replacement.
iovera° at a Glance
Treatment: Targeted cryoneurolysis using controlled cold
Primary Use: Temporary relief of pain and symptoms associated with knee osteoarthritis
Also Used: In selected patients before or around total knee replacement as part of a broader pain-management plan
Medication: None is delivered to the targeted nerve
Duration of Effect: Pain relief may last up to 90 days; individual response varies
Procedure Type: Minimally invasive, needle-based treatment performed in the office
Goal: Temporarily reduce pain signals from selected peripheral sensory nerves
Recovery: Most patients return home after treatment, with temporary soreness, numbness, swelling, or bruising possible
What Is iovera°?
iovera° is a medical device that uses a technique called cryoneurolysis to temporarily interrupt pain signals traveling through selected peripheral nerves.
Rather than injecting medication into a joint, iovera° applies controlled cold through a small needle-based device to a targeted sensory nerve.
The cold temporarily disrupts the nerve's ability to transmit pain signals while preserving the structures that allow the nerve to recover over time.
As the nerve gradually regenerates, normal signaling returns.
The treatment does not repair damaged cartilage or reverse osteoarthritis. Its purpose is to temporarily reduce pain signals as one part of an individualized knee-pain treatment plan.
Learn more about knee pain and orthopedic knee care.
How Does iovera° Work?
Pain signals travel through peripheral nerves from the knee toward the brain.
During iovera° treatment, a clinician identifies selected sensory nerves associated with the painful area and applies controlled cold to those nerves.
The cold creates a temporary interruption in nerve signaling.
Unlike a permanent nerve-destruction procedure, the treatment effect is intended to wear off as the nerve regenerates.
Pain relief can last up to approximately 90 days, although the amount and duration of benefit vary from patient to patient.
iovera° does not numb the entire leg and is designed to target selected sensory nerve branches while preserving normal function.
What Is Cryoneurolysis?
Cryoneurolysis is a technique that uses very cold temperatures to temporarily interrupt signaling through a peripheral nerve.
The concept is different from placing ice on the outside of the knee.
With cryoneurolysis, controlled cold is delivered directly to a selected nerve through a specialized device.
The nerve's pain-transmitting components are temporarily disrupted, while the connective structure of the nerve remains intact so that normal nerve function can return as regeneration occurs.
iovera° is one device used to perform this type of treatment.
Who May Be a Candidate for iovera°?
iovera° may be considered for selected patients with knee pain when temporarily reducing pain signals could help improve comfort or support a broader treatment plan.
Knee Osteoarthritis
iovera° is indicated for temporary relief of pain and symptoms associated with osteoarthritis of the knee.
It may be considered when knee arthritis continues to cause pain despite appropriate conservative treatment or when another temporary pain-management option is desired.
iovera° does not treat the underlying loss of cartilage.
Patients should still address the broader management of knee osteoarthritis through exercise, physical therapy, activity modification, medications when appropriate, and other treatments based on their individual condition.
Learn more about arthritis treatment.
Before Knee Replacement Surgery
iovera° may also be considered for selected patients preparing for total knee replacement.
By temporarily reducing pain signals from selected nerves, treatment may be incorporated into a broader perioperative pain-management and rehabilitation strategy.
It does not replace anesthesia, postoperative medication, physical therapy, or the other components of knee-replacement recovery.
Whether iovera° is appropriate before surgery should be determined by your orthopedic care team.
Learn more about total joint replacement.
Patients Who Are Not Ready for Knee Replacement
Some patients have symptomatic knee arthritis but are not yet ready for joint replacement or may need to postpone surgery for medical or personal reasons.
For selected patients, iovera° may offer another temporary pain-management option while a longer-term treatment plan is developed.
It should not be viewed as a permanent alternative to joint replacement when advanced arthritis ultimately requires surgery.
Who May Not Be a Candidate for iovera°?
iovera° is not appropriate for everyone.
The manufacturer identifies several conditions in which the treatment should not be used, including certain disorders involving abnormal reactions to cold and open or infected wounds near the treatment area.
Tell your clinician about your complete medical history before treatment, particularly if you have:
unusual sensitivity or reactions to cold;
Raynaud's disease;
cold urticaria;
cryoglobulinemia;
paroxysmal cold hemoglobinuria;
an active infection or open wound near the treatment area;
bleeding concerns;
or another medical condition that may affect treatment.
Your clinician will determine whether iovera° is appropriate based on your health, symptoms, diagnosis, examination, and treatment goals.
What Happens During an iovera° Procedure?
iovera° is typically performed as an outpatient procedure.
The exact process may vary depending on which sensory nerves are being treated.
Before Treatment
Your clinician evaluates your knee pain and determines whether the symptoms and diagnosis make you an appropriate candidate for cryoneurolysis.
The targeted treatment area is identified and prepared.
A local anesthetic may be used to help reduce discomfort from the procedure.
During Treatment
A small needle-based treatment tip is placed through the skin near the selected sensory nerve.
The iovera° device uses nitrous oxide within a closed system to generate a controlled cold zone at the treatment tip.
Cold is applied for a defined period to temporarily interrupt the nerve's ability to transmit pain signals.
More than one treatment location may be necessary depending on which nerves are being targeted.
After Treatment
The treatment areas are checked before you leave.
Temporary tenderness, numbness, swelling, bruising, redness, or altered sensation can occur.
Your clinician will provide instructions regarding activity, skin care, medications, and when you can resume exercise or strenuous activity.
Does iovera° Hurt?
Some discomfort is possible.
Local anesthetic may be used before treatment, but patients can still experience pressure, cold sensations, tenderness, or temporary discomfort associated with the needle-based procedure.
Afterward, mild soreness, bruising, swelling, numbness, or altered sensation around the treatment area can occur.
Experiences vary from patient to patient.
How Quickly Does iovera° Work?
Some patients may notice a change in knee pain shortly after treatment.
However, response varies, and immediate pain relief should not be guaranteed.
Cryoneurolysis studies have reported improvements in pain and function in some patients with knee osteoarthritis, but results differ across studies and individuals.
Your response should be evaluated based on meaningful improvements in pain and function rather than an expectation that every patient will experience the same result.
How Long Does iovera° Pain Relief Last?
The iovera° system is indicated for relief of knee osteoarthritis pain and symptoms for up to 90 days.
That does not mean every patient will receive exactly three months of relief.
The duration and degree of benefit can vary depending on the nerves treated, underlying knee condition, severity of symptoms, individual nerve regeneration, and other factors.
As the treated nerve regenerates, normal signaling gradually returns and pain may return.
Your clinician can discuss whether additional treatment or another approach is appropriate if symptoms recur.
What Are the Potential Benefits of iovera°?
For appropriately selected patients, potential advantages include:
temporary reduction in knee pain;
treatment targeted to selected sensory nerves;
no opioid medication delivered by the device;
no corticosteroid or other medication injected into the joint;
an outpatient treatment;
and the possibility of incorporating pain relief into physical therapy, activity, or surgical recovery.
These are potential benefits rather than guaranteed outcomes.
iovera° should be considered in the context of your overall diagnosis and treatment plan.
What Are the Risks & Side Effects of iovera°?
iovera° is a needle-based medical procedure and can cause side effects.
Common or expected treatment-site reactions can include:
bruising;
swelling;
redness;
local pain or tenderness;
numbness;
tingling;
or altered sensation.
Less common complications may include skin injury related to cold or heat, temporary changes in skin color, skin dimpling, or temporary loss of normal muscle function outside the intended treatment area.
Open or infected wounds near the treatment site and certain cold-sensitivity disorders are contraindications to treatment.
Your clinician should review the potential risks and benefits with you before the procedure.
Is iovera° the Same as a Knee Injection?
No.
Many nonsurgical knee treatments involve placing medication or another substance directly into or around the knee.
iovera° works differently.
It targets selected peripheral sensory nerves outside the joint and uses controlled cold rather than injecting corticosteroid, hyaluronic acid, platelet-rich plasma, or another medication into the joint.
Because the treatments work differently, the right option depends on your diagnosis, symptoms, prior treatments, and goals.
Is iovera° the Same as Radiofrequency Ablation?
No.
Both cryoneurolysis and radiofrequency procedures target nerves involved in pain signaling, but they use different forms of energy.
iovera° uses controlled cold.
Radiofrequency procedures use energy that creates heat or other electrical effects at the targeted nerve.
They also may target different nerves and have different indications, techniques, and evidence.
Your healthcare provider can determine whether either type of nerve-targeted treatment is appropriate for your condition.
Can iovera° Replace Knee Replacement Surgery?
iovera° does not repair damaged knee cartilage and does not reverse advanced osteoarthritis.
For a patient whose arthritis has progressed to the point that joint replacement is appropriate, temporary pain relief does not correct the underlying structural damage.
iovera° may sometimes be used while surgery is being planned, while a patient addresses medical issues before surgery, or as part of a pain-management strategy around knee replacement.
The decision to proceed with knee replacement should be based on your pain, mobility, X-rays, health, activity goals, and response to nonsurgical treatment.
Learn more about when knee replacement may be considered.
How Does iovera° Fit Into a Knee Arthritis Treatment Plan?
Knee osteoarthritis treatment is rarely based on one procedure alone.
Depending on your symptoms and stage of arthritis, treatment may include:
exercise;
physical therapy;
activity modification;
medications when appropriate;
selected injections;
bracing;
weight management when appropriate;
nerve-targeted treatments such as iovera° in selected patients;
and partial or total knee replacement when arthritis becomes advanced.
The best sequence depends on your diagnosis and how much the condition affects your daily life.
Learn more about osteoarthritis treatment options.
Physical Therapy After iovera°
Temporary pain reduction may make movement and exercise more comfortable for some patients.
When appropriate, physical therapy can focus on the underlying limitations associated with knee arthritis, including mobility, strength, balance, walking mechanics, and function.
Reducing pain alone does not restore strength or joint function.
If physical therapy is part of your treatment plan, the goal is to use improved comfort to support active rehabilitation whenever possible.
Learn more about physical therapy at Arthritis & Sports.
iovera° & Knee Replacement Recovery
For selected patients undergoing knee replacement, iovera° may be considered as one component of a broader perioperative pain-control strategy.
Research has evaluated cryoneurolysis before or around total knee arthroplasty for outcomes such as postoperative pain, opioid use, range of motion, and function.
Results are promising in some studies, but the evidence continues to evolve and the procedure should not be presented as necessary for every knee-replacement patient.
Your surgeon can determine whether nerve-targeted pain treatment has a role in your individual surgical plan.
Learn more about total knee and joint replacement.
Frequently Asked Questions About iovera°
Is iovera° an injection?
iovera° uses a small needle-based treatment tip that passes through the skin, but it does not inject medication into the targeted nerve. Controlled cold is delivered through the device to temporarily interrupt pain signaling.
Is iovera° permanent?
No. The treatment is designed to temporarily interrupt pain signaling. As the treated nerve regenerates, normal sensation and signaling return.
Does iovera° cure knee arthritis?
No. iovera° can temporarily reduce pain signals, but it does not rebuild cartilage or reverse osteoarthritis. The underlying arthritis remains and should be managed through an appropriate long-term treatment plan.
How long can iovera° work?
The device is indicated for relief of pain and symptoms associated with knee osteoarthritis for up to 90 days. Individual results vary, and not every patient experiences the same degree or duration of relief.
Can I have iovera° before knee replacement?
Selected patients may be candidates for iovera° before knee replacement as part of a broader perioperative pain-management strategy. Your surgical team can determine whether the procedure is appropriate for you and when it should be performed.
Can iovera° help me avoid knee replacement?
iovera° may temporarily reduce pain, but it does not reverse advanced arthritis. Some patients may use nonsurgical treatments to manage symptoms for a period of time, but patients with severe structural joint damage may eventually still benefit from knee replacement.
Can iovera° be repeated?
Because the nerve regenerates and pain may eventually return, repeat treatment may sometimes be considered. The decision depends on your previous response, diagnosis, health, and overall treatment plan.
Will insurance cover iovera°?
Coverage varies by insurance plan, diagnosis, medical necessity requirements, and other factors. Contact your insurance carrier or our office for information regarding your individual coverage and potential out-of-pocket costs.
Ask Whether iovera° Is Right for Your Knee Pain
If knee osteoarthritis is causing persistent pain and limiting walking, exercise, physical therapy, work, or everyday activities, an orthopedic evaluation can help determine which treatment options fit your condition.
iovera° may be one temporary, non-opioid pain-management option for selected patients with knee osteoarthritis or for certain patients preparing for knee replacement.
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