open access

Vol 13, No 2 (2019)
Review paper
Published online: 2019-06-05
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Radiofrequency — an interventional method of chronic pain treatment: mechanisms of analgesic action, indications and application in selected pain syndromes

Hanna Justyna Kucia1, Małgorzata Malec-Milewska1, Agnieszka Sękowska12
·
Palliat Med Pract 2019;13(2):70-75.
Affiliations
  1. Out-patient Pain Clinic 1Department of Anaesthesiology and Intensive Care, Medical Centre of Postgraduate Education, Warszawa, Czerniakowska 231, 00-416 Warsaw, Poland
  2. 1Department of Anaesthesiology and Intensive Care, Medical Centre of Postgraduate Education, Warszawa, Czerniakowska 231, 00-416 Warszawa, Poland

open access

Vol 13, No 2 (2019)
Review paper
Published online: 2019-06-05

Abstract

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).

Abstract

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).
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Keywords

radiofrequency, pulsed radiofrequency, interventional pain management, chronic pain management, occipital neuralgia, trigeminal neuralgia , facet joint syndrome

About this article
Title

Radiofrequency — an interventional method of chronic pain treatment: mechanisms of analgesic action, indications and application in selected pain syndromes

Journal

Palliative Medicine in Practice

Issue

Vol 13, No 2 (2019)

Article type

Review paper

Pages

70-75

Published online

2019-06-05

Page views

1305

Article views/downloads

1193

DOI

10.5603/PMPI.2019.0011

Bibliographic record

Palliat Med Pract 2019;13(2):70-75.

Keywords

radiofrequency
pulsed radiofrequency
interventional pain management
chronic pain management
occipital neuralgia
trigeminal neuralgia
facet joint syndrome

Authors

Hanna Justyna Kucia
Małgorzata Malec-Milewska
Agnieszka Sękowska

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