Kooky new pain treatment: smart ice implants
Two pages on PainSci cite Reeder 2022: 1. Icing for Injuries, Tendinitis, and Inflammation 2. Kooky new pain treatment: smart ice implants
PainSci commentary on Reeder 2022: ?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.
Imagine if you could ice a nerve directly. Like right on it. Implanted. Ice almost literally in your veins.
And then tinker with the temperature.
Pretty cool! (🙄)
So this is now a thing (though not yet a product).
Reeder et al. report that they have cooked up a strange new high-tech treatment for pain: soft, bioresorbable coolers for a reversible block of peripheral nerves. So we’re talking about nerve blocks with a little freezer instead of anaesthetic, basically — and you can fiddle with the temperature.
The branding, obviously, would have to be “Smart Ice.” (It’s not literally ice, of course. But it’s definitely therapeutic icing in spirit.)
This is weird, but it’s not crazy. The principle is sound. But the devil will be in the details, as with most medical technology. And some of those details are:
- It’s invasive, obviously, so that just automatically means that there’s some risk, no matter how good it is.
- You can only block what you can locate, so this will fail in most cases of pain without a clear origin of the pain. Which is many kinds of chronic pain.
- We know that even trying to destroy nerves often fails, for many reasons. If destroying them fails, so will chilling. I discuss this issue in my nerve block article.
But this is a fascinating new technique, and I imagine it could be quite useful in some cases. Reeder et al. may well get rich.
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
Implantable devices capable of targeted and reversible blocking of peripheral nerve activity may provide alternatives to opioids for treating pain. Local cooling represents an attractive means for on-demand elimination of pain signals, but traditional technologies are limited by rigid, bulky form factors; imprecise cooling; and requirements for extraction surgeries. Here, we introduce soft, bioresorbable, microfluidic devices that enable delivery of focused, minimally invasive cooling power at arbitrary depths in living tissues with real-time temperature feedback control. Construction with water-soluble, biocompatible materials leads to dissolution and bioresorption as a mechanism to eliminate unnecessary device load and risk to the patient without additional surgeries. Multiweek in vivo trials demonstrate the ability to rapidly and precisely cool peripheral nerves to provide local, on-demand analgesia in rat models for neuropathic pain.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Topical glyceryl trinitrate (GTN) and eccentric exercises in the treatment of mid-portion achilles tendinopathy (the NEAT trial): a randomised double-blind placebo-controlled trial. Kirwan 2024 Br J Sports Med.
- Placebo analgesia in physical and psychological interventions: Systematic review and meta-analysis of three-armed trials. Hohenschurz-Schmidt 2024 Eur J Pain.
- Recovery trajectories in common musculoskeletal complaints by diagnosis contra prognostic phenotypes. Aasdahl 2021 BMC Musculoskelet Disord.
- Cannabidiol (CBD) products for pain: ineffective, expensive, and with potential harms. Moore 2023 J Pain.
- Moderators of the effect of therapeutic exercise for knee and hip osteoarthritis: a systematic review and individual participant data meta-analysis. Holden 2023 The Lancet Rheumatology.