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What is the iovera° treatment?

The ioverao treatment uses the body’s natural response to cold to treat peripheral nerves and immediately reduce pain – without the use of drugs. Treated nerves are temporarily stopped from sending pain signals for a period of time, followed by a restoration of function.

It is important to note that the ioverao therapy does not treat the underlying cause of the pain.  Timely remediation is necessary to address and treat the cause of pain.

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.

The iovera° Treatment

Treatment Results for Chronic Pain

Decreased Knee Pain

More than 75% of the patients who received ioverao treatment continued to experience pain relief at 150 days.

Less Stiffness 

More than 50% of the patients treated with the ioverao system experienced less stiffness 12 weeks after treatment.

Improved Physical Function

Majority of the patients in the ioveraotreatment group had improved physical function at 150 days.

Treatment Results for Acute (surgical) Pain

Fewer Opioid Prescriptions 

Patients who received the ioveraotreatment requested 45% fewer opioid prescriptions at 12 weeks after knee replacement surgery.

Reduction in Knee Pain

Patients who received the ioverao treatment requested 45% fewer opioid prescriptions at 12 weeks after knee replacement surgery.

Faster Recovery

Post-surgical recovery was much faster in patients who received the ioverao treatment before knee replacement surgery.

Is the iovera° treatment for me?

If your pain is chronic, due to osteoarthritis, it can be alleviated by cryoanalgesia with the ioverao treatment.  The ioverao system has also been shown to help in reducing opioid consumption in patients after surgery.  Post-surgical pain is considered to be acute pain.

The ioverao treatment is a focused therapy.  Therefore, there are no systemic side effects that are typically experienced with NSAIDs, narcotics or other medications.  Nothing is injected into the treatment area by the ioverao system.  Therefore, very few, if any, localized side effects due to the ioverao treatment have been observed and side effects are mild.  Please click here to see the complete list of indications, contraindications and side effects of the ioveraosystem.  You should consult with your physician to determine if cryoanalgesia with the ioverao system will benefit you.

What To Expect

Prior to treatment, your physician will discuss any daily medications you take, such as blood thinners or pain medications, as well as your health history and any health conditions you may have.  Please discuss your treatment history with your physician before your scheduled ioverao treatment appointment:

  • Previous surgery. treatment, trauma or a medical diagnosis in the area to be treated
  • A history of keloid formation, reactions to Lidocaine or sensitivity to pain or cold
  • Open sores or wounds in the are to be treated
  • Regular use of anti-coagulants (e.g. Coumadin, fish oil), aspirin or NSAIDs (e.g. ibuprofen)

There are no special pre-treatment instructions for you to follow:

  • Wear comfortable clothing that allows access to the treatment area (e.g. for knee treatments, consider shorts)

Your physician or his office staff will:

  • Assess your pain
  • Clean and mark the treatment area
  • Numb the area with an anesthetic injection or cold spray (you may feel a slight pinch)
  • Treatment takes around 15-30 minutes per area treated.
  • You may feel pressure or tugging when the iovera° Smart Tip is inserted.
  • During the treatment, it is normal to experience cold, warm or tingling sensations as well as some level of discomfort, often described as pressure.
    • Treatment should not be painful; if you feel pain, tell your provider right away.

Immediately following treatment:

  • Apply pressure (10 – 15 minutes) to the treatment area to reduce swelling  or bruising
  • Apply ice after applying pressure

When at home follow these simple instructions

  • Keep the treatment area clean and dry during healing.
  • Use ice or over-the-counter pain medication to relieve soreness.
  • Your physician can offer you guidance on medication.
  • Unless specifically directed, avoid blood-thinning drugs (ibuprofen, aspirin) for 48 hours; acetominophen is an option.
  • Avoid exercise or exertion for 2 – 3 days.
  • Your physician will advise you on returning to normal activities and safe levels of exertion or stress.
  • Treatment area may feel tender and / or warm.
  • Some numbness or mild tingling may be present in the treatment area.
  • Some swelling and / or bruising may occur.


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.

Common side effects include local pain, tenderness, swelling, bruising and tingling or numbness.  Typically, these reactions resolve with no physician intervention.  For a complete list of side effects, please click here.

Post-treatment activity instructions are at the discretion of your physician.  You may return to non-strenuous activity immediately after receiving the ioverao treatment.  However, your physician may have additional instructions prior to any planned surgery.  Consult your physician regarding appropriate levels of activity.

To learn more about ioverao treatment please visit

Physician Assistant

Jennifer Krieg, PA-C