May 8, 2014

Cooled radiofrequency ablation to treat knee and hip pain

One of our goals in interventional pain medicine is to develop new ways of treating pain, particularly options other than taking medications.  The treatment of osteoarthritis of the knees and hips is one such therapy.  Many people have pain in the knees or hips.  This pain can come from osteoarthritis.  It can come from an altered gait caused by low back pain.  You can after pain in the hips or knees despite having had previous hip or knee surgery.  Some people may need hip or knee replacement, but don’t want to have it.  They may be too young and are afraid that if they have surgery now, they will have to have repeat surgery if the new knee or hip wears out.  They may be too old and not want to have the rehabilitation necessary after knee or hip surgery.

Before now, there were limited options for these people.  Acetaminophen does not work for everyone.  Anti-inflammatories can cause stomach upset and have heart side effects.  Even strong pain relievers, like opioids, are not always effective.

Now, we can treat these problems using a process called cooled radiofrequency.  Radiofrequency is a means of placing heat by nerves so that the nerves stop carrying pain information.   If the area which the nerves supply is a source of pain, causing the nerves carrying this pain information to stop carrying the pain means that you don’t hurt.  One problem with radiofrequency is that the lesion is small, about as wide as the tips of two pencils.  Cooled radiofrequency allows one to make a larger lesion.  This is important to us as doctors because it allows us to treat nerves when we know where the nerves are, but the exact location may vary a little between patients.  The larger area of the lesion allows us to treat the nerve without having to be directly on it.

The procedure is very effective.  There are some studies looking at how effective the procedure is and more studies are underway.  The procedure does not affect your ability walk.  Because of decreased pain, you should be able to walk better.

The procedure is safe and well tolerated.  It is usually done as an outpatient.  It is well tolerated, so that patients who are too sick to have a major operation can usually have cooled radiofrequency ablation with no problem.

Cooled radiofrequency ablation of the sensory branches of the hip and knees is a new, effective treatment of pain in the hips and knees for which one cannot have surgery or does not want to have surgery or for which one has already had surgery.

Please contact The Helm Center for more information about this exciting new treatment of hip and knee pain.