Cryoneurolysis Techniques in Pain Management

Cryoneurolysis encompasses the application of extremely low temperatures to peripheral nerves in order to induce a reversible conduction block, affording targeted analgesia that can last from weeks to several months. By creating a controlled ice ball at the nerve interface, axonal structures undergo temporary degeneration (axonotmesis) while preserving the basal lamina and endoneurial sheaths, allowing complete regeneration without neuroma formation. Techniques range from landmark-based probe placement to real-time ultrasound guidance, with or without adjunct fluoroscopic imaging. The procedure has been deployed in acute settings such as postoperative thoracic and orthopaedic pain, and in chronic indications including osteoarthritic joint pain, neuropathic syndromes and phantom limb discomfort. Advances in probe design and temperature monitoring have refined the size and shape of cryolesions, optimising nerve coverage while minimising collateral tissue injury. As a non-pharmacological, opioid-sparing modality, cryoneurolysis has drawn increasing interest for its capacity to improve functional recovery, reduce analgesic requirements and lower the risk of long-term opioid exposure. Current challenges lie in standardising protocols, establishing long-term safety profiles and defining comparative efficacy against other neuroablative and neuromodulatory interventions.

Research from Nature Portfolio

No recent Nature Portfolio content available.

Cryoneurolysis Techniques in Pain Management publication trend

The graph below shows the total number of articles in cryoneurolysis techniques in pain management across all publications each year (not limited to Nature Index journals).

Technical terms

Cryoneurolysis: The reversible destruction of nerve fibres by focal application of subzero temperatures, resulting in temporary conduction block.

Cryoanalgesia: Analgesia achieved through cold-induced nerve inactivation without surgical excision.

Percutaneous: A minimally invasive approach involving needle or probe insertion through the skin under imaging or landmark guidance.

Axonotmesis: A form of nerve injury in which axons and myelin are disrupted while connective tissue structures remain intact, allowing regeneration.

Ultrasound-guidance: The use of real-time sonographic imaging to visualise anatomical structures and guide interventional devices.

References

1. A Narrative Review of Ultrasound-Guided and Landmark-based Percutaneous Cryoneurolysis for the Management of Acute and Chronic Pain. Current Pain and Headache Reports (2024).
2. Cryoneurolysis Is a Safe, Effective Modality to Improve Rehabilitation after Total Knee Arthroplasty. Life (2022).
3. Cryoneurolysis of the Subcostal Nerve: A Technical Description and Case Report. Cureus (2024).