Evidence‐based Status of Pulsed Radiofrequency Treatment for Patients with Shoulder Pain: A Systematic Review of Randomized Controlled Trials

Liu, An; Zhang, Wei; Sun, Miao; Ma, Chiyuan; Yan, Shigui

doi:10.1111/papr.12310

Cited by 22 publications

(18 citation statements)

References 30 publications

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“… 40 Furthermore, a neuromodulatory effect has been suggested via alternating gene expression (eg, c-Fos, ATF-3) in pain processing neurons by which PRF treatment may provide long-lasting pain relief. 9 , 18 , 41 On these bases, in order to interpret our observations, we might suggest a potential reduction in central sensitization secondary to a decrease in nociceptive stimuli, which would be in line with the hypothesized nociceptive and neuropathic nature of HSP. 3 Moreover, we cannot exclude some kinds of neural tissue modification due to the PRF transient “heat spikes” (~45°C to 50°C around the needle tip, depending on the tissue impedance as reported in the literature), whose ablative effect is unknown.…”

Section: Discussionsupporting

confidence: 57%

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A retrospective case series of ultrasound-guided suprascapular nerve pulsed radiofrequency treatment for hemiplegic shoulder pain in patients with chronic stroke

Picelli

Lobba

Vendramin³

et al. 2018

JPR

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PurposeHemiplegic shoulder pain (HSP) is the most common pain condition after stroke. Pulsed radiofrequency (PRF) treatment of the suprascapular nerve (SSN) effectively relieves shoulder pain conditions. To date, there is no study about the effects of PRF treatment for HSP. Thus, our aim was to report on a case series about its use in chronic stroke.Patients and methodsSix chronic stroke patients with HSP (visual analog scale [VAS] score for pain ≥30 mm) underwent ultrasound-guided SSN PRF treatment. All were evaluated before treatment and at 4 and 16 weeks of follow-up. The main outcome was VAS score. Secondary outcomes were Modified Ashworth Scale, shoulder passive range of motion (PROM), Disability Assessment Scale (DAS), Fugl-Meyer Assessment, and EuroQol-5 dimension questionnaire (EuroQol-5D) scores.ResultsAs compared with baseline, improvement was observed in the following parameters: VAS for pain (at 4 weeks, P=0.023; at 16 weeks, P=0.023); shoulder PROM for abduction (at 4 weeks, P=0.023; at 16 weeks, P=0.024), flexion (at 4 and 16 weeks, P=0.024), extension (at 4 and 16 weeks, P=0.02), and external rotation (4 and 16 weeks, P=0.02); DAS for hygiene (at 4 and 16 weeks, P=0.024), dressing (at 4 weeks, P=0.02; at 16 weeks, P=0.024), and pain (at 4 weeks, P=0.024; at 16 weeks, P=0.023); and EuroQol-5D (at 4 and 16 weeks, P=0.024).ConclusionOur observations support the use of ultrasound-guided SSN PRF treatment for HSP in chronic stroke patients.

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Section: Discussionsupporting

confidence: 57%

“… 14 , 15 As to the use of SSN PRF treatment for shoulder pain, a good clinical efficacy lasting for 6 months with scant complications has been reported in the literature. 17 , 18 …”

Section: Introductionmentioning

confidence: 99%

A retrospective case series of ultrasound-guided suprascapular nerve pulsed radiofrequency treatment for hemiplegic shoulder pain in patients with chronic stroke

Picelli

Lobba

Vendramin³

et al. 2018

JPR

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“…The unfavorable complications associated with an invasive surgical procedure such as infection, hematoma, or damage to the surrounding tissue should not be ignored. As an alternative technique, pulsed radiofrequency, a non-pharmacological and less invasive treatment method, can improve severe persistent joint pain (14)(15)(16)(17)(18)(19)(20). However, there are limited evidence-based data on the impact of pulsed radiofrequency on chronic knee pain.…”

mentioning

confidence: 99%

Bipolar Versus Unipolar Intraarticular Pulsed Radiofrequency Thermocoagulation in Chronic Knee Pain Treatment: A Prospective Randomized Trial

Güleç

2017

Pain Phys

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Background: Chronic knee pain is a major widespread problem causing significant impairment of daily function. Pulsed radiofrequency has been shown to reduce severe chronic joint pain as a non-pharmacological and less invasive treatment method. Objective: We aimed to compare the effectiveness of unipolar and bipolar intraarticular pulsed radiofrequency methods in chronic knee pain control. Study Design: Prospective, randomized, double-blind study. Setting: Pain clinic in Cukurova University Faculty of Medicine. Methods: One hundred patients, aged 20 – 70 years with grade 2 or 3 knee osteoarthritis were included in this study. Patients were randomly allocated into 2 groups to receive either unipolar (group U, n = 50) or bipolar (group B, n = 50) intraarticular pulsed radiofrequency (IAPRF) with a 45 V voltage, 2 Hz frequency, 42° C temperature, 10 msec pulse width, and 10 minute duration. We recorded visual analog scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index LK 3.1WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index LK 3.1) scores of patients at baseline and one, 4, and 12 weeks after the procedure. The primary outcome was the percentage of patients with ≥ 50% reduction in knee pain at 12 weeks after the procedure. Results: There was a significant difference between the groups according to VAS scores at all post-intervention time points. In group B, 84% of patients, and in the group U, 50% of patients achieved at least 50% knee pain relief from the baseline to 3 months. In group B, WOMAC scores were significantly lower than the group U at one and 3 months. Limitations: Lack of long-term clinical results and supportive laboratory tests. Conclusion: Bipolar IAPRF is more advantageous in reducing chronic knee pain and functional recovery compared with unipolar IAPRF. Further studies with longer follow-up times, laboratorybased tests, and different generator settings are required to establish the clinical importance and well-defined mechanism of action of PRF. This study protocol was registered at clinicaltrials.gov (identifier: NCT02141529), on May 15, 2014. Institutional Review Board (IRB) approval date: January 16, 2014, and number: 26/9 Key words: Chronic pain, intraarticular, knee joint, knee osteoarthritis, pain management, pulsed radiofrequency treatment, quality of life, recovery of function

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“…Some old techniques have been improved and adapted to be minimally invasive, such as the radiofrequency thalamotomy [94,95]. There are also new interesting additions, like the genicular nerve cooled radiofrequency neurotomy to treat chronic knee pain [96,97], the obturator and femoral nerve sensory percutaneous neurotomy to deal with hip problems [98,99], the shoulder pulsed radiofrequency of the suprascapular and axillary nerve to treat chronic pain shoulder [100,101] or the epicondyle radiofrequency treatment for chronic elbow pain [102,103]. All these and other less common surgical procedures are there to be considered and used in selected cases [87,104].…”

Section: Future Trendsmentioning

confidence: 99%

Where We Come From and Are We Aware of Where We Are Going To?

Vanaclocha¹,

Saiz-Sapena²,

Ortiz-Criado³

et al. 2021

Chronic Pain - Physiopathology and Treatment

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Chronic pain is a pathological condition that requests specific medical attention. Its treatment has been imperative since the origin of our species, taking advantage of herbs and natural remedies available in the primitive environment. Morphine has stood the test of time as has been continuously used for the past 8 millennia. The anatomical knowledge of the nociceptive sensation pathways led to the introduction of some surgical techniques directed to stop this pain transmission. Due to their aggressiveness and to the fact that they are irreversible, these techniques were soon replaced by neurostimulation procedures. Being reversible and allowing a change in stimulation parameters soon became the preferred treatment strategy. Over the years a small subset of patients continues to suffer from chronic pain refractory to the usual neurostimulation and pain-controlling medications. These patients can perhaps benefit from one of the surgical ablative procedures. Some of these techniques have been proven particularly effective throughout the years. For some limited income patients in underdeveloped countries, these techniques may be their only accessible option. Doctors have to keep in mind these surgical techniques to put them at the service of our patients in the very few cases in which they are needed. Letting these ablative techniques to die in oblivion would be a disservice to our patients.

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Evidence‐based Status of Pulsed Radiofrequency Treatment for Patients with Shoulder Pain: A Systematic Review of Randomized Controlled Trials

Cited by 22 publications

References 30 publications

A retrospective case series of ultrasound-guided suprascapular nerve pulsed radiofrequency treatment for hemiplegic shoulder pain in patients with chronic stroke

A retrospective case series of ultrasound-guided suprascapular nerve pulsed radiofrequency treatment for hemiplegic shoulder pain in patients with chronic stroke

Bipolar Versus Unipolar Intraarticular Pulsed Radiofrequency Thermocoagulation in Chronic Knee Pain Treatment: A Prospective Randomized Trial

Where We Come From and Are We Aware of Where We Are Going To?

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