Cooled Radiofrequency Ablation (Cooled RFA) is an advanced form of radiofrequency treatment used to manage chronic nerve-related pain, particularly in larger or deeper joints like the knee, hip, and sacroiliac (SI) joint.
At PainMed, we use cooled RFA to offer precise, longer-lasting relief for patients whose pain has not responded to injections, medications, or conservative therapies.
Cooled RFA works similarly to conventional radiofrequency ablation — it interrupts pain signals by applying heat to sensory nerves. However, it uses internal water cooling to maintain a lower temperature at the probe tip while creating a larger lesion around the target nerve.
Cooled RFA is typically used in cases where broader nerve coverage is needed, such as:
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Chronic sacroiliac (SI) joint pain
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Knee osteoarthritis (when genicular nerve blocks have been successful)
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Hip joint pain (from osteoarthritis or post-surgical sources)
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Lumbar facet joint pain (in selected cases)
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Post-joint replacement pain (where other causes have been excluded)
It’s a functional, rehabilitative approach to chronic back pain — ideal for those whose pain is due to motor control failure, not nerve damage.
Cooled RFA is typically used in cases where broader nerve coverage is needed, such as:
The patient lies comfortably and the skin is numbed with local anaesthetic.
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Under fluoroscopy (X-ray) or ultrasound guidance, a specialised cooled RFA needle is placed next to the target nerve.
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After sensory testing to confirm nerve location, the system applies radiofrequency energy, while simultaneously circulating fluid to prevent tissue charring.
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The treatment typically takes 30–60 minutes, and is done as a day procedure.
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Cooled RFA is a safe, well-tolerated procedure when performed by experienced clinicians. Risks may include:
Cooled RFA may be suitable for patients with:
This treatment may help reduce opioid dependence and support return to functional activity.
Explore Cooled RFA at PainMed
If you or your patient is experiencing difficult-to-treat joint or back pain, cooled radiofrequency may offer a minimally invasive path to longer-term relief.
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Originally from England, Sally graduated from St George’s Hospital, University of London in 2004 with a BSc (First Class Hons) in Physiotherapy. Since settling in Australia, Sally has worked in private practice and in the public hospital setting across Sydney.
Sally gained a Masters in Medicine Pain Management from the University of Sydney in 2019 and is a Titled Pain Physiotherapist (as awarded by the Australian Physiotherapy Association).
In addition to private practice, Sally currently works as a Senior Physiotherapist at Westmead Hospital Pain Management Service.
Sally is highly skilled in assessing, diagnosing and treating people who experience chronic pain. She enjoys working with injured workers and CTP claimants. She has a deep understanding of the impact of pain on the whole person and on their functioning in daily life. In partnership with her colleagues, Sally enjoys applying her knowledge and clinical skills to provide a safe space for exploration of the physical and emotional meaning of pain and for recovery of function.
Qualifications and Experience
Dr. Adam is a Fellowship-trained Pain Medicine Specialist with a Fellowship from the Faculty of Pain Medicine (FFPMANZCA) and a Master of Pain Medicine from the University of Sydney. He is dedicated to the comprehensive management of chronic pain across all age groups.
Dr. Adam trained in adult pain medicine at Liverpool Hospital, Nepean Hospital, and the Department of Pain Medicine, and completed additional training in paediatric chronic pain at The Children’s Hospital at Westmead. He currently serves as a Staff Specialist at Westmead and St George Public Hospitals (NSW Health), and is a Visiting Medical Officer (VMO) at Liverpool Public Hospital, St George Private, Sydney Southwest Private, Holroyd Private, Norwest Private, and Nepean Private Hospitals.
He adopts a whole-person, multidisciplinary approach rooted in the socio-psycho-biomedical model, utilising both pharmacologic and interventional techniques. These include:
Dr. Adam is an Authorised Prescriber of Medicinal Cannabis and holds a Diploma in Medicinal Cannabis. He is also certified in Opioid Treatment Programs, including Methadone. His areas of interest include opioid dependence management, medicinal cannabis, and interventional pain procedures.
He also completed advanced training in Virtual Reality Therapy for chronic pain and mental health disorders in Barcelona, Spain, and has further qualifications in Focused Psychological Strategies, Cognitive Behavioural Therapy (CBT), and Clinical Hypnosis.
Qualifications:
