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COOLIEF* Cooled Radiofrequency

Written and reviewed by
MBBS, MD - Anaesthesiology, DNB Anaesthesiology, PDCC - Pain Management
Pain Management Specialist, Mumbai  •  14years experience
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I am Dr. Sidharth Verma, Pain Management Specialist, Pain Relief Center, Mumbai. Today I will talk about cooled radiofrequency. It is a very advanced procedure. It was developed after the radiofrequency treatment. In this treatment, there is a higher success rate. There are very high chances of achieving good results with this treatment. There are a variety of reasons for that. The first advantage is that this treatment involves cooled radiofrequency. This means that the ablation which is done by a small needle which has a higher area. Because the heat is decapitated very fast. And this results in a higher area of effectiveness. Results in better targeting of the nerves. In this treatment, nerves are targeted which is giving rise to the pain. And you pain physician will target these nerves. He will ablate them with the help of the radiofrequency. And cooled radiofrequency is one step ahead. This gives much better control to your physician and longer lasting relief to the patient. So, the major application of this cooled radiofrequency is in the knee joint and facet joint. So, why knee and facet?

Because in the knee there are 3 genicular nerves which are generally targeted. These are very small nerves. And the indication is knee osteoarthritis. But these nerves are very small and difficult to locate them. So, if the cooled radiofrequency is used, this is very helpful in locating these nerves and destroying them. Hence, resulting in pain relief. The other possible application for this cooled radiofrequency in the facet joint. So, we often get patients who are suffering from back pain in whom the MRI is normal. So, most probably you are suffering from the myofascial syndrome or facet joint arthropathy or facet joint pain. These facets are small joints in the vertebrae. Between vertebrae, there are 2 joints, one on the left and one on the right side. Once the facet becomes hypotrophy or becomes arthritic, they give rise to facet joint pain. And this pain is reflected as back pain. It is a very characteristic pain, depending on the facet involved. If it is the upper level like 1, 2, 3, the pain mostly will be restricted to the back. But if it is in the lower level like 4 & 5, the pain will radiate to the posterior portion of the hip or just above the knee also.

This characteristic is known as facet pain. You can also identify it with a simple test. You can just try to extend your back and this pain typically aggravates. It also increases while you are turning your sides. This is treated by the median branch block. It is a nerve which supplies the facet joints and it passes to a very close junction. So, this is very difficult to locate these nerves because there is a lot of anatomical variation. And this is where cooled radiofrequency plays a big role. And this cooled radiofrequency equipment gives the bigger lesion. Hence, the finding out nerve chances is very high. It gives a better result and good long lasting results. So, if you are suffering from knee pain or back pain or if you don't want to undergo surgery of the knee joint and you want to explore the alternative option, so, this cooled radiofrequency is a very good option for you. Secondly, if you are suffering from back pain and your MRI is normal then you must immediately visit your pain physician. We are here to help you at the pain relief centre. And thereafter we can properly diagnose. And if you have facet joint as the possible cause then we can do cooled radiofrequency procedure for you. This can result in better relief in you symptoms. To know more, you can visit my Lybrate website.

Thank You!

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