Cold Therapy May Reduce Pain, Narcotic Use After Rotator Cuff Surgery

Study finds patients who used cold therapy units had lower opioid use and pain scores after arthroscopic rotator cuff repair.

Mar. 30, 2026 at 8:50pm

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A new study presented at the American Academy of Orthopaedic Surgeons Annual Meeting found that patients who underwent arthroscopic rotator cuff repair surgery and used a cold therapy unit afterwards experienced a significant reduction in postoperative narcotic use and lower pain scores compared to a control group. The results have led to cold therapy becoming more accessible to Medicare patients through the Non-Opioids Prevent Addiction in the Nation Act.

Why it matters

Rotator cuff surgery is one of the most painful orthopedic procedures, with a high rate of opioid addiction among patients. Reducing reliance on narcotics after these surgeries is crucial to preventing long-term opioid dependence. This study shows that a simple cold therapy regimen can help achieve that goal, with potential benefits for patient recovery and public health.

The details

Researchers collected patient-reported outcomes like VAS, DASH, and ASES scores before and after surgery, and also had patients track their opioid use in a pain diary. Patients who used a cold therapy unit (Iceman, Enovis/Donjoy) after their rotator cuff repair had significantly lower total morphine milligram equivalents and lower pain scores in the first postoperative week compared to a historical control group that did not use cold therapy.

  • The study was presented at the American Academy of Orthopaedic Surgeons Annual Meeting in New Orleans in 2026.
  • The Non-Opioids Prevent Addiction in the Nation Act, which expanded Medicare coverage for non-opioid pain treatments like cold therapy, was established in 2022.

The players

Sara L. Edwards, MD

A professor of orthopedic surgery at the University of California San Francisco who led the research on the benefits of cold therapy after rotator cuff surgery.

Iceman

A cold therapy unit made by Enovis/Donjoy that was used in the study.

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What they’re saying

“[Cold therapy] is something that actively decreases narcotic consumption, so we can theoretically prescribe less postoperatively.”

— Sara L. Edwards, MD, Professor of Orthopedic Surgery, University of California San Francisco

“Rotator cuff surgery is the most painful sports surgery that we do. It has the highest rate of addiction of sports medicine surgery. That is a big issue with us.”

— Sara L. Edwards, MD, Professor of Orthopedic Surgery, University of California San Francisco

What’s next

Additional research should look at how cold therapy impacts the outcomes of other orthopedic procedures beyond just rotator cuff repair.

The takeaway

This study demonstrates that a simple, non-opioid pain management technique like cold therapy can significantly reduce narcotic use and pain levels after one of the most painful orthopedic surgeries. Expanding access to these types of non-addictive treatments is crucial to curbing the opioid epidemic, especially among vulnerable elderly patients.