Case Report: Successful Pain Relief with Cooled Radiofrequency Ablation in Two Patients with Chronic Pain

Chronic lower back pain and knee osteoarthritis-related pain are common and often refractory to conservative and interventional treatments. Conventional radiofrequency ablation (RFA) is limited by its narrow lesion size and the risk of tissue injury. Cooled RFA (C-RFA) creates larger and more spherical lesions, potentially improving its efficacy and safety. Two patients with chronic pain who were unresponsive to prior therapy underwent C-RFA. A 59-year-old man with discogenic L2/3 back pain experienced near-complete relief of axial and radicular symptoms that persisted for 17 months after transdiscal C-RFA. A 61-year-old woman with severe knee osteoarthritis (Kellgren–Lawrence grade 4) received C-RFA targeting the genicular nerves, resulting in substantial pain reduction (Numerical Rating Scale: 9→1) and improved function. C-RFA provides significant and durable pain relief in patients with chronic discogenic back pain and advanced knee osteoarthritis. The ability to create large, uniform lesions may offer benefits in both areas requiring extensive lesion coverage and anatomically complex regions. These cases suggest that C-RFA is an effective interventional option for refractory chronic pain and warrant further studies.