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UCI Health pain medicine expert helps patient deal with arthritis and avoid knee replacement

Twist on radio frequency ablation adds cooling to the procedure, relief for the patient

March 26, 2019

An active person for most of his life, Richard Maples of Tustin loved playing golf. However, five years ago, he was diagnosed with stage 4 arthritis in both knees, which kept him from continuing his passion for the sport. He also stopped running and hiking.

“I was always in pain, said Maples, 65. “There was no position I could get in where the pain didn’t go away.”

According to the Centers for Disease Control and Prevention, almost 15 million U.S. adults live with severe joint pain related to arthritis.

Maples had seen several doctors over the years who treated him with knee-lubricating shots that temporarily eased his pain, but last year his insurance stopped covering it. He searched for non-surgical solutions and learned about “Coolief,” a procedure that uses radio frequencies to burn portions of the nerves responsible for sending pain signals from the body to the brain.

“This is a good alternative for people who have pain and are trying to delay having a joint replacement,” said Dr. Shalini Shah, an anesthesiologist and chief of pain services at UCI Health, performed his ablation procedure. “It is also effective at relieving the severe pain that many patients experience after hip or knee replacement surgeries.”

Shah uses local anesthesia on the affected area and some sedation medication to make the patient comfortable. Small needles are used to locate the nerves and guide the probe. Once the probe is inserted, it only takes a few minutes to burn and destroy the nerve tissue.

Maples was home and back to regular activities that same afternoon.

“Dr. Shah’s amazing. I trust her 100 percent,” said Maples. ”I highly recommend Dr. Shah and this procedure. I told a coworker about this, and hope he checks it out.”

The Coolief procedure is minimally invasive and takes less than an hour to relieve pain for up to a year. Shah said it also reduces the need for pain management medication.


UCI Health comprises the clinical enterprise of the University of California, Irvine. Patients can access UCI Health at primary and specialty care offices across Orange County and at its main campus, UCI Medical Center in Orange, California. The 417-bed acute care hospital provides tertiary and quaternary care, ambulatory and specialty medical clinics, and behavioral health and rehabilitation services. UCI Medical Center is home to Orange County’s only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program and American College of Surgeons-verified Level I adult and Level II pediatric trauma center and regional burn center. UCI Health serves a region of nearly 4 million people in Orange County, western Riverside County and southeast Los Angeles County. Follow us on Facebook and Twitter.