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Pulsed Radiofrequency Safe and Effective for Pain Relief in Low Back Pain
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Pulsed Radiofrequency Safe and Effective for Pain Relief in Low Back Pain

Highlights:
  • Low back pain and sciatica (pain radiating from lower back to the leg) is a common condition seen in patients caused by bulging of the intervertebral disk which presses on the nerve roots in the spine
  • Pulsed radiofrequency (pRF) is a minimally invasive treatment that offers superior pain relief in patients with low back pain and sciatica that does not respond to more conservative measures such as pain killers and steroid injections
  • Patients treated with pulsed radiofrequency had good pain relief and a faster rate of recovery compared to patients treated with local steroid injections

Pulsed radiofrequency (pRF) offers better and faster pain relief in patients with low back pain and sciatica caused by bulging intervertebral disk that does not improve with painkillers and steroid injections, according to a new study at the Sapienza University of Rome in Italy. The findings of the study are being presented at the yearly meeting of the Radiological Society of North America (RSNA).

Pulsed Radiofrequency - Alternative Form of Pain Relief for Low Back Pain

Low back pain and sciatica are commonly encountered conditions due to bulging of the jelly-like intervertebral disc material. The bulged disc material presses upon the nerve roots in the spinal cord resulting in moderate to severe pain. The pain is initially managed with painkillers such as paracetamol and NSAIDs (ibuprofen), and for more severe pain, localized corticosteroid injections are advised. If these measures fail, then costly and invasive surgical procedures may be opted for pain relief.

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Now an alternative form of pain relief called pulsed radiofrequency has been found to be more effective than steroid injections and may help avoid further costly and invasive surgery to the spine.

Alessandro Napoli, M.D., Ph.D., senior author and professor of interventional radiology at Sapienza University of Rome in Italy, said: "Pulsed radiofrequency creates a nerve modulation, significantly reducing inflammation and its associated symptoms."
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Comparing Pulsed Radiofrequency with Localized Steroid Injections
  • Scientists compared the efficacy of pulsed radiofrequency with localized steroid injections in patients who did not show improvement despite painkillers. The study included about 128 participants
  • Pulsed radiofrequency (pRF) treatment was directly administered to the involved nerve root under CT guidance for about 10 minutes
  • For comparison, CT guided localized steroid injections was given to another group of 120 patients
  • During the one year follow-up period, pRF treatment was found to be superior and more effective compared to steroid injections
  • Relief of back and leg pain was both better and quicker with pRF
  • The number of patients who perceived pain relief and improvement was significantly higher (95%) in the pulsed radiofrequency group compared to those who received steroid injections (61%)
The findings of the study seem to suggest that pulsed radiofrequency (pRF) treatment is superior to current medical treatments and steroid injections, as well as helping these patients avoid invasive and costly surgical procedures.

Dr. Napoli says, "Given our study results, we offer pulsed radiofrequency to patients with a herniated disk and sciatic nerve compression whose symptoms do not benefit from conservative therapy."

Pulsed Radiofrequency Treatment and Its Merits

Pulsed radiofrequency (PRF) is a minimally invasive procedure using high frequency current to stun the painful nerve root. Although there may be an initial flare-up of pain, it then settles down to significantly lower levels.

Advantages of Pulsed Radiofrequency Treatment
  • Minimally invasive
  • Relieves pain faster and better
  • Safe and long lasting
  • Often a single session of 10 minutes may be sufficient
  • Low-cost treatment and non-repetitive
  • Invasive and costly surgical procedures can be avoided
In conclusion, pulsed radiofrequency (pRF) may be a boon to patients with intractable low back pain and for those who wish to avoid more invasive and expensive treatments.

In the words of Dr. Napoli, "There is a big gap between conservative treatments for disk compression and herniation and surgical repair, which can lead to infection, bleeding, and a long recovery period. Evolving technologies like this image-guided treatment may help a substantial number of patients avoid surgery."

References :
  1. Pulsed Radiofrequency Relieves Acute Back Pain and Sciatica - (https://press.rsna.org/timssnet/media/pressreleases/14_pr_target.cfm?id=2045)


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