Pulsed radiofrequency application in the treatment of chronic pain (original) (raw)
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The British journal of radiology, 2017
The objective of this review was to evaluate the efficacy of pulsed radiofrequency (PRF) treatment of pain associated with different spinal conditions. The mechanisms of action and biological effects are shortly discussed to provide the scientific basis for this radiofrequency modality. We systematically searched for clinical studies on spinal clinical conditions using PRF. We searched the MEDLINE (PubMed) database. We classified the information in one table focusing on randomized controlled trials (RCTs) and other types of studies. Date of last electronic search was October 2016. We found four RCTs that evaluated the efficacy of PRF on cervical radicular pain and five observational studies. Two trials and three observational studies were conducted in patients with facet pain. For disc-related pathology, we found one RCT with PRF applied intradiscally and three RCTs for dorsal root ganglia PRF modulation lumbosacral radicular pain. For sacroiliac joint pain, spondylolisthesis, malig...
Acta Neurochirurgica, 2011
Background The objective of this review is to evaluate the efficacy of Pulsed Radiofrequency (PRF) treatment in chronic pain management in randomized clinical trials (RCTs) and well-designed observational studies. The physics, mechanisms of action, and biological effects are discussed to provide the scientific basis for this promising modality. Methods We systematically searched for clinical studies on PRF. We searched the MEDLINE (PubMed) and EMBASE database, using the free text terms: pulsed radiofrequency, radio frequency, radiation, isothermal radiofrequency, and combination of these. We classified the information in two tables, one focusing only on RCTs, and another, containing prospective studies. Date of last electronic search was 30 May 2010. The methodological quality of the presented reports was scored using the original criteria proposed by Jadad et al. Findings We found six RCTs that evaluated the efficacy of PRF, one against corticosteroid injection, one against sham intervention, and the rest against conventional RF thermocoagulation. Two trials were conducted in patients with lower back pain due to lumbar zygapophyseal joint pain, one in cervical radicular pain, one in lumbosacral radicular pain, one in trigeminal neuralgia, and another in chronic shoulder pain. Conclusion From the available evidence, the use of PRF to the dorsal root ganglion in cervical radicular pain is compelling. With regards to its lumbosacral counterpart, the use of PRF cannot be similarly advocated in view of the methodological quality of the included study. PRF application to the supracapular nerve was found to be as efficacious as intra-articular corticosteroid in patients with chronic shoulder pain. The use of PRF in lumbar facet arthropathy and trigeminal neuralgia was found to be less effective than conventional RF thermocoagulation techniques.
JPMA. The Journal of the Pakistan Medical Association, 2011
To observe the effect of Pulsed radiofrequency on patients presenting with complaints of chronic pain. It was a retrospective cross sectional study which included patients with chronic pain who did not respond to conventional treatment.The study was conducted at the Pain Management Centre, Dicle University, Diyarbakir, Turkey from October 2008 to September 2010. The applications of Pulsed radiofrequency (PRF) were made under the guidance of C-arm fluoroscopy, local anaesthesia, and sedoanalgesia. The intervention types applied consisted of sacroiliac intraarticular, heel, sciatic nerve and impar ganglion Pulsed radiofrequency. Visual Analogue Scale (VAS) was used for pain assessment.Sacroiliac intraarticular PRF was applied to nine patients, impar ganglion PRF to eight patients, heel PRF to four patients and sciatic nerve PRF was applied to three patients. The mean age of the patients was 41.3 +/- 16.9 (range 15-77) years, 15 (62.5%) were females. The mean follow-up period was 8.5 +...
Radiofrequency and pulsed radiofrequency treatment of chronic pain syndromes: the available evidence
Pain practice : the official journal of World Institute of Pain
There are currently 6 reviews on (pulsed) radiofrequency (RF) for the management of spinal pain. Two reviews on interventional pain management techniques in general also discuss RF. The outcomes of those reviews depend on the type of studies included and the opinion of the reviewers, which may result in different evidence levels. Radiofrequency denervation at the cervical and lumbar level has produced the most solid evidence. The differences in treatment outcome registered in the 5 randomized controlled trials (RCTs) regarding lumbar facet denervation can be attributed to differences in patient selection and/or inappropriate technique. There is not sufficient evidence supporting the use of RF facet denervation for the management of cervicogenic headache. The studies examining the management of cervical radicular pain suggest a comparable efficacy for RF and pulsed RF (PRF). The PRF treatment is supposed to be safer and therefore should be preferred. The superiority of RF treatment a...
Pulsed radiofrequency in lumbar radicular pain: clinical effects in various etiological groups
Pain practice : the official journal of World Institute of Pain, 2007
The purpose of this study was to evaluate the effectiveness of pulsed radiofrequency (PRF) applied to the lumbar dorsal root ganglion (DRG). A retrospective analysis of 54 consecutive patients who underwent 75 PRF procedures was performed. The patients were divided into three groups according to the etiology of the lesion (herniated disc [HD], spinal stenosis [SS], and failed back surgery syndrome [FBSS]). The analgesic efficacy of the technique was assessed using a 10-point Numeric Rating Scale (NRS) at baseline and, along with the Global Perceived Effect (GPE), at 30, 60, 90, and 180 days. The reduction in medications and the number of complications associated with the technique were assessed. A decrease in the NRS score was observed in patients with HD (P < 0.05) and SS (P < 0.001), but not in those with FBSS. The GPE scores confirmed this finding. No complications were noted. We observed that PRF of the DRG was significantly more efficacious in HD and SS than in FBSS patie...
January 2018, 2018
Background: Pulsed radiofrequency (PRF) is increasingly used in clinical practice, especially in neuropathic pain disorders. Although PRF is not new to clinical use, there are significant gaps in knowledge regarding its effectiveness. Objectives: The current study was conducted to evaluate the effect of duration of application of PRF on its analgesic efficacy in improvement of neuropathic pain. Study Design: A randomized experimental trial. Setting: An animal research facility at the College of Veterinary Medicine at Mansoura University in Egypt. Methods: Chronic constriction of the sciatic nerve of 36 male Sprague-Dawley rats was performed to induce neuropathic pain. The rats were divided into 6 groups (6 rats each) in which PRF was applied for 2, 4, 6, or 8 minutes or not at all. In one group, RF cannula was applied without performing PRF intervention. The pain was assessed through observation of resting paw posture (RPP) at 3, 10, and 21 days. Nerve damage was assessed by histopa...
Effectiveness of pulsed radiofrequency in chronic lumbosacral radicular pain
Background: Lumbosacral radicular pain is one of the most common clinical features which accounts for more than 10% of the hospital visits annually. Multiple treatment strategies have been in use to manage it. This study aimed to assess the efficacy of pulsed radiofrequency (PRF) in treating pain and physical disturbances in chronic lumbosacral radicular pain. Methodology: Forty patients, suffering from lumbosacral neuropathic pain were treated by PRF at the corresponding level (ranging from L3 to S1). Outcome measures included the pain intensity score on a 0-10 numeric rating scale (NRS) at pretreatment, after two months and six months post-treatment. Results: A significant reduction in pain scores was observed in mean NRS at two and six month duration (p < 0.001). The NRS after treatment with PRF was significantly reduced compared to that before PRF treatment (3.28 vs. 8.38 and 4.25 vs. 8.38 respectively) after two and six months. Conclusion: The PRF is effective in the treatment of chronic lumbosacral radicular pain of neuropathic features.
The Clinical Journal of Pain, 2019
Objectives: Despite the interest in scientific community, there is still poor evidence about pulsed radiofrequency (PRF) efficacy in the treatment of neuropathic pain. In order to determine whether highvoltage PRF and epidural adhesiolysis (PRF-EA) showed better results than epidural adhesiolysis alone (EA), a randomized, doubleblind, comparative-effectiveness study was conducted in patients with chronic lumbosacral radiating pain and neuropathic features. Materials and Methods: A total of 41 patients were randomly allocated to 2 groups. Twenty-one patients were randomized to receive 2 cycles of 240 seconds high-voltage PRF followed by the injection of local anesthetics, hyaluronidase, and betamethasone, whereas 20 patients underwent sham stimulation followed by adhesiolysis. The treatment was delivered at the affected lumbosacral roots and patients, treating physicians and assessors were blinded to intervention. Results: A significant reduction of radiating pain was observed in mean Numeric Rating Scale score at follow-up. A change of −3.43 versus −1.75 (P = 0.031) after 1 month and −3.34 versus −0.80 (P = 0.005) after 6 months was reported in patients undergoing PRF-EA in comparison with EA, respectively. After 1 month, 57% of patients in the PRF-EA group experienced a pain reduction of ≥ 50% versus only 25% of patients allocated to EA (P = 0.037). Improvement decreased to 48% in the PRF-EA group whereas only 10% of EA reported significant pain relief after 6 months (P = 0.008). Discussion: High-voltage PRF of dorsal root ganglion delivered through multifunctional electrode provided significant pain relief and may be considered a valuable treatment in chronic lumbosacral radicular pain with neuropathic features.