Evolution and Mode of Action of Pulsed Radiofrequency

Sluijter, Menno E.; Imani, Farnad

doi:10.5812/aapm.10213

Cited by 43 publications

(37 citation statements)

References 19 publications

(20 reference statements)

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“…Several nonoperative and operative strategies have been introduced and tested for treatment of chronic coccydynia, with controversial results. The available nonoperative modalities include using donut pillows, physical therapy and massage, radiofrequency ablation of the coccyx, injection of glucocorticoids into the coccyx, and different coccygeal manipulations (4, 8, 11-16). For those who are resistant to medical and physical therapy, surgical resection of the mobile portion of the coccyx and coccygectomy is recommended (5, 17, 18).…”

Section: Introductionmentioning

confidence: 99%

Effects of Extracorporeal Shock Wave Therapy on Pain in Patients With Chronic Refractory Coccydynia: A Quasi-Experimental Study

Haghighat

Asl

2016

Anesth Pain Med

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BackgroundSeveral nonsurgical and surgical treatment modalities are available for patients with chronic coccydynia, with controversial results. Extracorporeal shock wave therapy (ECSWT) is effective in the treatment of many musculoskeletal disorders; however, it has not been tested for chronic coccydynia.ObjectivesWe performed the current study to determine the effects of ECSWT on pain in patients with chronic coccydynia.Patients and MethodsThis quasi-interventional clinical study included 10 patients with chronic coccydynia without acute fracture. All the patients received ECSWT with a radial probe delivering 3,000 shock waves of 2 bar per session at 21 Hz frequency directed to the coccyx. Each patient received four sessions of ECSWT at one-week intervals. The pain severity was recorded according to the visual analog scale (VAS) at one, two, three, and four weeks after initiation of therapy. The VAS score was also evaluated at one and six months after ending the therapy.ResultsMost of the participants were women (90.0%), and the participants’ mean age was 39.1 ± 9.1 (ranging from 28 to 52) years. The VAS score did not decrease significantly seven months after therapy when compared to baseline (3.3 ± 3.6 vs. 7.3 ± 2.1; P = 0.011). However, the VAS score at two months (2.6 ± 2.9 vs. 7.3 ± 2.1; P = 0.007) and at four weeks (3.2 ± 2.8 vs. 7.3 ± 2.1; P = 0.007) significantly decreased when compared to baseline. The decrease in VAS scores was not persistent after cessation of the therapy.ConclusionsECSWT is an effective modality in relieving the pain intensity in patients with refractory chronic coccydynia for the early period after intervention.

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Section: Introductionmentioning

confidence: 99%

Effects of Extracorporeal Shock Wave Therapy on Pain in Patients With Chronic Refractory Coccydynia: A Quasi-Experimental Study

Haghighat

Asl

2016

Anesth Pain Med

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“…Pole elektryczne wytwarzane przez PRF może zmienić sygnał bólowy oraz selektywnie wpłynąć na niezmielinizowane włókna C [4][5][6][7]. Biologiczne skutki słabego pola elektrycznego (9 V, 42°C) polegające na hamowaniu potencjału działania komórek, udowodnił między innymi Cahana, który obserwował skutki metod PRF i CRF na wybranych strukturach mózgu (hipokamp) [8].…”

Section: Wstępunclassified

“…The electric field produced by PRF can change the pain signal and selectively affect unmyelinated type C fibres [4][5][6][7]. Biological effects of a weak electric field (9 V, 42°C) consisting in inhibiting the action potential of cells has been proven by, among others, Cahana, who observed the effect of PRF and CRF on selected cerebral structures (hippocampus) [8].…”

Section: Introductionmentioning

confidence: 98%

Termolezja — interwencyjna metoda leczenia przewlekłego bólu: mechanizmy działania przeciwbólowego, wskazania oraz zastosowanie w wybranych zespołach bólowych

2019

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Conventional radiofrequency (CRF) is an interventional chronic pain treatment method with the use of electromagnetic waves at the frequency of radio waves (or higher) consisting in a controlled use of high temperature in order to destroy sympathetic and/or sensory fibres. Application time equals 60s and the temperature achieved in the tissues, depending on the application site, 60-90ºC. Pulsed radiofrequency (PRF) constitutes another treatment method which also uses radio waves at high frequencies. It consists in implementing series of 20ms current injections at frequencies of 2 Hz with a specific voltage (2-45 V), which results in an increase of the temperature around the electrode up to 42-50ºC. According to the International Association for Study of Pain (IASP), an indication for the application of interventional methods is chronic pain resistant to pharmacological treatment, as well as non-invasive methods, with a positive response to a prognostic blockade. This article discusses both the mechanism of conventional and pulsed radiofrequency, its application in specific pain syndromes, the most common complications and its side effects. The efficacy and safety of CRF and PRF in the treatment of lumbosacral pain, pain in knee joints, occipital neuralgia, painful shoulder syndrome, neuralgia/trigeminal neuropathy, peripheral neuropathy, neuropathic pain of the sympathetic system and cancer pain was presented based on data from literature. It seems that the application of radiofrequency and its applicability in certain pain syndromes is well-documented (trigeminal neuralgia, Horton's headache, osteoarthritis of the interspinous joints), while further research is required to develop a methodology for the radiofrequency procedure of knee joints or occipital nerves, despite promising results. The possibility of using more and more precise imaging methods constitutes a significant factor in order to carry out the procedure in an effective and safe way (USG, computed tomography, laser techniques, 3D printing). Med Pract 2019; 13, 2: 70-75 Palliat

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“…Applying radiofrequency (RF) currents to neural tissue has been proposed for the treatment of neuropathic pain in different locations, such as in small and large joints 1 and dorsal root ganglia. 2 RF currents were initially used in an ablative mode, applying a nonpulsed voltage to cause heat destruction at tissue temperatures over 50 • C, 3 so that the technique has become known as continuous RF (CRF). In general, RF currents have been applied in a monopolar mode, i.e., between a smallsize electrode tip accurately placed on the target neural tissue and a large dispersive electrode (patch) in contact with the patient's skin.…”

Section: Introductionmentioning

confidence: 99%

Computer modeling of electrical and thermal performance during bipolar pulsed radiofrequency for pain relief

Pérez¹,

Pérez-Cajaraville²,

Muñoz³

et al. 2014

Med. Phys.

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The results suggest that (1) the clinical parameters considered to be suitable for bipolar CRF should not necessarily be considered valid for bipolar PRF, and vice versa; and (2) the ablative effect of the CRF mode is mainly due to its much greater level of delivered energy than is the case in PRF, and therefore at same applied energy levels, CRF, and PRF are expected to result in same outcomes in terms of thermal damage zone dimension.

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Evolution and Mode of Action of Pulsed Radiofrequency

Cited by 43 publications

References 19 publications

Effects of Extracorporeal Shock Wave Therapy on Pain in Patients With Chronic Refractory Coccydynia: A Quasi-Experimental Study

Effects of Extracorporeal Shock Wave Therapy on Pain in Patients With Chronic Refractory Coccydynia: A Quasi-Experimental Study

Termolezja — interwencyjna metoda leczenia przewlekłego bólu: mechanizmy działania przeciwbólowego, wskazania oraz zastosowanie w wybranych zespołach bólowych

Computer modeling of electrical and thermal performance during bipolar pulsed radiofrequency for pain relief

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