Efficacy of pulsed radiofrequency in controlling pain caused by spinal disorders: a narrative review

Yang, Seoyon; Lee, Hee Jin

doi:10.21037/apm-20-298

Cited by 10 publications

(12 citation statements)

References 64 publications

(176 reference statements)

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“…This allows time for heat elimination and maintains the temperature of the target tissue below 42°C. Temperatures below 42°C rarely induce nerve tissue damage [ 17 - 24 ]. Therefore, adverse effects that can develop after the C-reactive protein procedure do not occur after the PRF procedure.…”

Section: Basic Theory Of Action Of Pulsed Radiofrequencymentioning

confidence: 99%

“…Therefore, major complications rarely occur after PRF. Since its introduction, PRF has been widely used for various types of pain, such as neuropathic, joint, discogenic, and muscular pain [ 21 - 24 ] ( Fig. 1 ).…”

Section: Introductionmentioning

confidence: 99%

“…To date, several clinical studies have demonstrated its positive analgesic effect [ 21 - 24 ]. In addition, many researchers have attempted to identify the mechanisms of action of PRF in alleviating pain.…”

Section: Introductionmentioning

confidence: 99%

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The mechanism of action of pulsed radiofrequency in reducing pain: a narrative review

Park

Chang

2022

J Yeungnam Med Sci

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Pain from nervous or musculoskeletal disorders is one of the most common complaints in clinical practice. Corticosteroids have a high pain-reducing effect, and their injection is generally used to control various types of pain. However, they have various adverse effects including flushing, hyperglycemia, allergic reactions, menstrual changes, immunosuppression, and adrenal suppression. Pulsed radiofrequency (PRF) is known to have a pain-reducing effect similar to that of corticosteroid injection, with nearly no major side effects. Therefore, it has been widely used to treat various types of pain, such as neuropathic, joint, discogenic, and muscle pain. In the current review, we outlined the pain-reducing mechanisms of PRF by reviewing previous studies. When PRF was first introduced, it was supposed to reduce pain by long-term depression of pain signaling from the peripheral nerve to the central nervous system. In addition, deactivation of microglia at the level of the spinal dorsal horn, reduction of proinflammatory cytokines, increased endogenous opioid precursor messenger ribonucleic acid, enhancement of noradrenergic and serotonergic descending pain inhibitory pathways, suppression of excitation of C-afferent fibers, and microscopic damage of nociceptive C- and A-delta fibers have been found to contribute to pain reduction after PRF application. However, the pain-reducing mechanism of PRF has not been clearly and definitely elucidated. Further studies are warranted to clarify the pain-reducing mechanism of PRF.

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Section: Basic Theory Of Action Of Pulsed Radiofrequencymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The mechanism of action of pulsed radiofrequency in reducing pain: a narrative review

Park

Chang

2022

J Yeungnam Med Sci

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“…Spine disease is one of the most common diseases in surgery, with the neck and shoulder pain, vertigo, and headache as the main clinical manifestations, and some patients may also suffer from lower limb pain due to involvement, unable to walk upright, or even paralysis in the severe cases, which has adverse effects on the quality of life of patients [ 1 , 2 ]. In recent years, due to the interaction of a variety of factors, the incidence of spinal diseases increases year by year, and the clinical treatment of spinal diseases has become the main focus of attention [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Analysis of Fast-Track Surgery with Pain Care on Postoperative Pain Improvement and Complication Prevention in Perioperative Spine Surgery Patients

Xie

Liu

et al. 2022

Emergency Medicine International

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Objective. The study aimed to analyze the effect of fast-track surgery with pain care on the improvement of postoperative pain and the prevention of postoperative complications in perioperative spinal surgery patients. Methods. A total of 126 patients undergoing spinal surgery from January 2021 to September 2021 were chosen as the study population, and the patients were classified into the regular group, the FTS group, and the combined group by random grouping, with 42 cases in each group. Patients in the regular group used routine perioperative care in spine surgery, patients in the FTS group used the FTS care model, and patients in the combined group combined special pain care on the basis of the FTS group. We compared the numeric rating scale (NRS) and pain severity of patients in the three groups post-op, 30 min, 1 h, 3 h, 6 h, and 24 h after surgery; we compared the time to get out of bed, length of stay, and occurrence of postoperative adverse effects in the three groups, compared the incidence of complications in the three groups, and compared the satisfaction of care in the three groups. Results. The NRS scores at 12 h, 24 h, 48 h, and 72 h post-op in the combined group and FTS group were lower than those in the regular group, and the NRS scores at 12 h and 24 h post-op in the combined group were lower than those in the FTS group (all P < 0.05 ); the post-op bed activity time, post-op hospitalization time, post-op adverse reaction rate, and post-op complication rate in the combined group and FTS group were shorter or lower than those of the regular group. Nursing satisfaction was higher than that of the regular group, the post-op time to bed activity in the combined group was shorter than that of the FTS group, and nursing satisfaction was higher than that of the FTS group (all P < 0.05 ). Conclusion. The use of FTS with pain care interventions helps relieve postoperative pain in perioperative patients in spine surgery, reduce the incidence of post-op adverse effects and complications in patients, accelerate their postoperative recovery, and improve nursing satisfaction.

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“…[8] Although it is a relatively new technique, the effectiveness of pulsed radiofrequency therapy has been evaluated in several pain conditions, including spinal disorders, low back pain, and peripheral neuropathies. [ 9 10 11 ] Unlike conventional continuous radiofrequency, which results in ablation of the involved nerve and surrounding tissue due to an internal temperature increase as high as 60°C to 80°C, pulsed radiofrequency is less invasive with temperature increases less than 45°C, which is considered as the threshold for irreversible tissue damage when exposed for longer than 20 seconds. [12] Pulsed radiofrequency applies brief electrical stimulations separated by long resting phases which is delivered in oscillatory currents (range 2000–3000/s) transforming into thermal energy that converts into heat, which results in increased blood circulation and tissue metabolism leading to an overall analgesic effect while avoiding structural damage.…”

Section: Introductionmentioning

confidence: 99%

Long-term efficacy and patient satisfaction of pulsed radiofrequency therapy in temporomandibular disorders

Jang

Chung

et al. 2021

Medicine

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Background: Pulse radiofrequency (PRF) therapy is one of effective physical therapy modalities for treat temporomandibular disorders (TMD). This prospective randomized controlled trial aimed to evaluate the long-term treatment efficacy and patient satisfaction with PRF therapy in TMD. Methods: Eighty-six female patients with TMD were randomly assigned to either pulsed radiofrequency or placebo therapy in combination with other conventional treatments once a week for 12 weeks. A final analysis was performed 12 weeks after the completion of treatment. Clinical parameters and patient satisfaction were analyzed at baseline, 4, 8, and 12 weeks of intervention and at 24 weeks from baseline. Results: Pain intensity, comfortable and maximum mouth opening, and pain on capsule and masticatory muscle palpation were significantly improved after treatment in both groups. Notably, the pulsed radiofrequency group showed a significantly lower pain intensity at the final evaluation performed 3 months after the completion of treatment. Significantly more patients reported subjective pain improvement and satisfaction with treatment following intervention at baseline in the PRF group. Most patients did not report any discomfort following treatment in either group. However, significantly more patients in the PRF group reported a burning sensation with intervention. Conclusion: Long-term regular pulsed radiofrequency therapy was effective in significantly reducing TMD pain, and the effect was long-lasting following treatment completion. Pulsed radiofrequency therapy should be considered as a supportive physical therapy modality for TMD.

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Efficacy of pulsed radiofrequency in controlling pain caused by spinal disorders: a narrative review

Cited by 10 publications

References 64 publications

The mechanism of action of pulsed radiofrequency in reducing pain: a narrative review

The mechanism of action of pulsed radiofrequency in reducing pain: a narrative review

Analysis of Fast-Track Surgery with Pain Care on Postoperative Pain Improvement and Complication Prevention in Perioperative Spine Surgery Patients

Long-term efficacy and patient satisfaction of pulsed radiofrequency therapy in temporomandibular disorders

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