Follow up: CoolSculpting nerve pain and correlation to other factors.

Question

I posted the other day and am getting vague answers. I am concerned about my chance for late onset nerve pain. I am petite and had three small applicators on abdomen. I am two days out and don't have much tingling or numbness but am bruised, swollen and tender. The clinical trials I've read had about ten percent experience late onset nerve pain, but doesn't have correlation to body type or early symptoms. Please address my question and not tell me bruising is normal.

Jeffrey B. Wise, MD, FACS · Answer

Delayed onset pain usually occurs 4 days after the treatment has been performed. It's more commonly indicated with the older applicators. Patients who experience DOP are usually very uncomfortable. At our practice we use the new applicators and we have seen less patients with this side effect. If you are having DOP I would recommend calling the office you were treated at. We offer our patients a 2 week prescription of a nerve blocking medication to alleviate these symptoms. Best of luck!

Jason Emer, MD · Answer

It is impossible to predict who will develop nerve pain, however it is unlikely. If there is a development of nerve pain, it can be treated with oral neurontin. Keep in mind, it will take 3-6 months for final results with Coolsculpting. For best results with Coolsculpting, I recommend a combination approach. I recommend adding radiofrequency treatments like Vanquish, Venus Legacy, Exilis Ultra for skin tightening and with Z wave/Cellutone for skin smoothing. VASER with ThermiRF is a great alternative. See an expert. Best, Dr. Emer

Monika Soni, MD · Answer

Thank you for your question. There is more of a possibility of developing late-onset nerve pain with the first generation handpieces. However, this is more common with the larger handpieces. However, if you do develop nerve pain it can be treated with lidocaine patched or Neurontin. I recommend having a follow up with your treating physician to address your concerns. Best of Luck!

Hardik Soni, MD · Answer

Thank you for your question. With the first generation hand pieces there is more of a possibility of developing late onset nerve pain. However, this is more common with the larger hand piece, not with the smaller hand piece used on you. We have seen less of late onset nerve pain with the second generation hand pieces. However, if you develop this it can be treated with lidocaine patches or Neurontin. I hope this information is helpful. Best of Luck!

Edward Stokes, MD · Answer

Hi jlw52, thank you for your question.  As you are aware, there is a 10% chance that anyone who has the Coolsculpting procedure performed will experience late onset pain.  This is a very random figure, however, and is not ascribed to any particular body type.  Unfortunately, there is no way to tell if you will be one of those ten percent who experience a higher level of discomfort post treatment.  This may be why you have been receiving answers that seem vague.  What would be most helpful in evaluating your individual situation is to know which generation of applicators were used to perform your procedure.  The older applicators, which used a deeper suction cup and were much more uncomfortable, caused a lot a patients to experience late onset pain.  If you were treated with the newer generation of Cool Advantage applicators, it would be highly unlikely that you will have the late onset pain.  I hope this sheds a little light on the situation.  Congratulations on having CoolSculpting. Good luck with your results!

Patrick L. Basile, MD · Answer

Hi jlw52- Post CoolSculpting symptoms vary per patient. For treatments on the abdomen area, it is very common for some patients to experience late-onset pain/ sharp pains due to inflammation.  Gabapentin is the recommended prescription remedy to alleviate this type of nerve pain. Gabapentin blocks the noxious stimuli associated with inflammation. I would recommend you speak with your provider about prescribing a low-dose Gabapentin script if you experience pain. You may also try other natural remedies such as massage, stretching, compression garments, and heating or cooling pads.    My Best, Dr. Basile

Christa Clark, MD, FACS · Answer

Question for you: do you know what generation hand piece your provider used?In the clinical trials with the first generation hand pieces there were some cases of 'late onset nerve pain' this was common with the larger hand piece, not the smaller hand piece used on you (as you stated above.) We have seen less of this with the second generation applicators.

Spero Theodorou, MD · Answer

Some swelling and bruising is normal:) In all seriousness some patients have a type of deep onset pain after treatment with cool sculpting which can last for a one-three months. Usually it presents after one week of treatment and it can be quite severe. It does not happen often but when it does the only thing recommended is non steroidal anti inflammatory medication which can be found over the counter. If its truly nerve pain-neurontin can help. This usually does the trick but takes a couple weeks to sometimes months  to improve. Either way you should consult with your doctor that performed the procedure.

Jennifer Cova, DO · Answer

With Coolsculpting it is very individual to each patient.  I'm unclear if you are 'expecting' nerve pain, or concerned since you are not experiencing it.  Most patients we have seen using new CoolAdvantage applicators have minimal to no pain, and minimal 'tenderness' or bruising.  This advanced technique has dropped the stats on those having late onset nerve pain.  It sounds like you had a good treatment, and are progressing nicely.  Goodluck with your future results.  :)

Jean M. Casello, MD · Answer

There is no way to predict who will get nerve pain from coolsculpting.  The number of patients who actually develop this complication is small. In my experience the discomfort is easily controlled with medication and heat.  I have not seen the late onset of nerve pain that has been reported.  I would not worry about this. If it does occur your provider should be able to address it.

Follow up: CoolSculpting nerve pain and correlation to other factors.

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