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Temperature-Mediated Nerve Blocks in the Treatment of Pain

  • Neuromodulation (A Abd-Elsayed, Section Editor)
  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Analgesic hot and cold temperatures have been used for both conservative and ablative therapies for millennia. There are well-known locoregional neurovascular changes associated with the application of heat or ice in the literature and in practice. The oscillation between heat and cold has recently been identified as a synergistic mechanism of action with early translational results in humans.

Recent Findings

Recent mechanistic work in the feline model has demonstrated that a reliable, reversible nerve block can be achieved within a temperature range that is non-destructive (15–45°C). The underlying mechanism is a newly described hysteresis in the responsiveness of peripheral nerves to alternating thermal stimuli resulting in nerve blockade. Recently presented feasibility data reports positive results in subjects with occipital pain and peripheral scar pain in terms of pain and associated symptom improvement.

Summary

Temperature-mediated changes in pain and sensation have been observed for hot and cold applications at a variety of temperatures. Recent insights into the synergy between preheating followed by cooling resulting in peripheral nerve fiber block has potential in a variety of conditions in which peripheral nerve etiology is noted. Recent findings in chronic headache patients report decreased pain and symptom improvement. Further studies are ongoing to understand the indications for this novel therapy.

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Authors and Affiliations

  1. Center for Interventional Pain and Spine (CIPS), 160 North Pointe Blvd Suite 208, Lancaster, PA, 17603, USA

    Michael A. Fishman, Ashley M. Scherer, Ashley M. Katsarakes, Lexi Larson & Philip S. Kim

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  1. Michael A. Fishman
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  2. Ashley M. Scherer
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  3. Ashley M. Katsarakes
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  4. Lexi Larson
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Correspondence to Michael A. Fishman.

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Conflict of Interest

AMS and AMK are employees of the Center for Interventional Pain and Spine (CIPS). MAF and PSK have stock options in Thermaquil, LLC. CIPS received contracted research payments from Thermaquil.

Human and Animal Rights and Informed Consent

All reported studies/experiments with human or animal subjects performed by the authors have been previously published or presented and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).

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Fishman, M.A., Scherer, A.M., Katsarakes, A.M. et al. Temperature-Mediated Nerve Blocks in the Treatment of Pain. Curr Pain Headache Rep 25, 60 (2021). https://doi.org/10.1007/s11916-021-00978-9

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