Seventy patients with chronic refractory knee osteoarthritis pain were randomized to receive phenol neurolysis (n=35) or radiofrequency ablation (RFA) (n=35). Outcomes of interest were the effectiveness of pain relief as measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), changes in pain on the Numeric Rating Scale (NRS) scores, the incidence of adverse effects such as paresthesia, and comparisons of treatment efficacy over a three-month period. Overall, the results of the study revealed that both treatments provided significant pain relief with no major differences in efficacy or WOMAC and NRS scores between the two methods. However, phenol neurolysis had a higher rate of transient paresthesia. The findings suggest that both phenol neurolysis and RFA are viable options for managing KOA pain, with phenol neurolysis being a potentially lower-cost alternative to RFA despite its higher risk of transient nerve sensitivity.