For people living with chronic pain, finding lasting relief can feel like an endless search. A treatment called Iovera cryoneurolysis is offering new hope, and it is now available closer to home than many patients might realize. John Schirmer, a Certified Registered Nurse Anesthetist and non-surgical pain management specialist at Pullman Regional Hospital's Interventional Pain Management Clinic, explains how it works and who it can help.
What Is Iovera Cryoneurolysis?
The Iovera treatment uses extreme cold to temporarily disable the sensory nerves responsible for transmitting pain signals. A specialized needle, guided by ultrasound, is cooled to what is considered “extreme cold” using liquid nitrogen that flows internally through the device. Nothing is injected into the body; the nerve is simply frozen, interrupting its ability to send pain signals.
"The effects of the pain relief should start to be felt almost immediately after we're done," states Schirmer. Relief typically lasts around three months, though some patients experience longer results.
Who Can Benefit from Cryoneurolysis?
The range of conditions that Iovera can address is broader than many people expect. Schirmer treats patients with headaches, shoulder pain, knee pain, rib pain, foot pain, and even certain types of abdominal muscle pain. "If you're feeling any of those types of pain, come see me, and I'll tell you whether or not you're a good candidate based on my assessment," he urges.
One particularly exciting application is pre-surgical pain management. For patients preparing for a total knee replacement, receiving Iovera treatment a few weeks before surgery has been shown to meaningfully reduce post-operative pain. "There is a lot of data showing that it actually helps with reducing the pain after your surgery," Schirmer notes. "That's something no other procedure that I'm aware of does."
How Does Cryoneurolysis Compare to Other Treatments?
Unlike steroid injections, Iovera is entirely non-pharmacological, making it a strong option for patients who cannot tolerate steroids due to diabetes or other conditions. Compared to radiofrequency ablation, which uses heat to disable nerves, Iovera has one clear advantage: it works right away. Radiofrequency ablation can take up to two weeks to take effect.
The procedure itself is straightforward and well-tolerated. Patients remain awake throughout, with only local anesthesia required. "It should be what I would call mildly uncomfortable," Schirmer shares. "There should not be excruciating pain."
A Personal Passion for Pain Relief
Schirmer's dedication to pain management runs deep. As a combat medic in Iraq two decades ago, he assisted with procedures designed to prevent phantom limb pain in soldiers who had suffered traumatic amputations… work that ignited a lifelong passion. "Killing pain is just awesome," he emphasizes. "It's a very rewarding thing to do."
That passion is evident in the outcomes he describes: patients walking farther, moving more freely, and reducing their dependence on oral pain medications. "I have seen people have tears of joy, because they feel like they haven't had that kind of pain relief until after they've experienced it," he reflects.
To learn more about which types of pain can be treated at Pullman Regional Hospital, visit the Interventional Pain Management Services webpage.
May 5, 2026 | Last updated May 5, 2026
