Published on July 25, 2017

NMMC Offers New Procedure to Relieve Knee Pain

TUPELO, Miss.— North Mississippi Physical Medicine and Rehabilitation is offering the first and only radiofrequency treatment to be cleared by the U.S. Food and Drug Administration specifically for the relief of moderate to severe knee pain caused by osteoarthritis.

COOLIEF Cooled Radiofrequency Treatment was FDA cleared for knee pain in April based on results from a 151-patient prospective, randomized multi-center study comparing COOLIEF to intraarticular steroid injections in patients suffering from knee pain caused by osteoarthritis. The study found that at six months COOLIEF provided significantly greater and longer-lasting pain relief, improved physical function and higher patient satisfaction than the steroid injections.

“This technology is clinically proven to provide up to 18 months of pain relief, improved function and reduced need for medication,” explained Kevin Silver, D.O. “It can be a game-changer for people with debilitating arthritis. It’s not getting rid of the arthritis, but it can reduce the pain.”

Dr. Silver said osteoarthritis, which is caused by damage and breakdown of cartilage between bones, can lead to joint pain, swelling and stiffness. The prevalence of osteoarthritis is rising as both the age and weight of Americans continue to increase.

Initial treatments for knee pain include nonsteroidal anti-inflammatory drugs (NSAIDs), opioids and steroid injections. “Medication provides only short-term relief and comes with some potentially serious risks which include opioid abuse and dependence,” Dr. Silver said. “Steroid injections can provide relief for months at a time, but may have to be repeated for continued pain relief.”

While surgery can benefit some patients, Dr. Silver said not everyone is a candidate or is willing to undergo surgery. Patients suffering from chronic knee pain wait an average of nine years until they are ready or qualify for surgery. “I see many patients who suffer with chronic knee pain in my practice who are not immediate candidates for knee replacement surgery, but they still need pain relief. The procedure can also be performed on patients who have already had a total knee replacement yet continue to have pain,” Dr. Silver said. “Until now there have been few options available for these patients.”

With the COOLIEF procedure, local anesthesia is applied to the patient’s skin. Dr. Silver inserts specialized needles that emit radiofrequency energy, which burns the nerves responsible for sending pain signals to the brain. By delivering radiofrequency energy through water-cooled electrodes, more radiofrequency energy can be safely transmitted to create larger volume, spherically-shaped treatment areas that provide physicians the ability to use the best approach angle when treating nerves, especially those located within complex nerve courses that can be difficult to reach.

Before the actual procedure, though, Dr. Silver does what he calls a test shot to see if the procedure will help the patient. “We numb the skin then do a test to see if it offers short-term relief,” he said. “We ask our patients to do things during the test period that typically bother their knee and rate their pain while doing those activities. If they got relief from the test, we schedule the procedure. If it still hurts, then we can surmise that the procedure won’t help.”

Dr. Silver said the test shot has offered many patients such relief that they put off the actual procedure until their pain returns.

Patients leave the procedure with a small adhesive bandage where the probe inserted along with instructions to ice their knee and take it easy for the rest of the day. They can return to normal activities right away.

For more information, visit or call North Mississippi Physical Medicine and Rehabilitation at (662) 377-6610 or 1-800-THE DESK (1-800-843-3375). No referral is necessary.

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