A new study reveals that pulsed radiofrequency may help patients with low back pain that has not responded to conservative therapy.
Low back pain affects millions of people worldwide.
According to the National Institute of Neurological Disorders and Stroke in the United States, about 80 percent of adults experience low back pain at some point.
This type of pain can range in intensity, from a constant dull ache to an abrupt sharp sensation. It may result from muscle strains or from underlying conditions, such as a herniated disk or sciatica.
For most people, the pain is acute, lasting up to a few weeks. However, in about 20 percent of people with acute low back pain, the pain becomes chronic, lasting for 12 weeks or longer.
In 2009, authors of a study that had been conducted over 14 years determined that the prevalence of chronic low back pain has risen significantly — resulting in high levels of disability and missed work days.
According to new research, an alternative technique called pulsed radiofrequency can safely and effectively relieve acute lower back pain that had not responded to conservative treatments.
The study’s authors, from Sapienza University of Rome in Italy, presented their findings at the annual meeting of the Radiological Society of North America.
A variety of therapies exist for low back pain, depending on the cause and intensity. Doctors generally recommend alternating ice and heat to relax the muscles and reduce inflammation. Many find over-the-counter pain relievers, such as ibuprofen, effective.
Among many pharmaceutical options, a doctor may prescribe muscle relaxants, nonsteroidal anti-inflammatory drugs, and steroids to reduce inflammation, as well as corticosteroid injections.
Other common treatments include physical therapy, massages, and stretching. In severe cases, surgery may be an option.
Pulsed radiofrequency is a minimally invasive procedure, involving the application of energy pulses directly to the roots of the nerves near the spine, which are responsible for sending pain signals.
The new study investigated the potential for pulsed radiofrequency to relieve pain from disk herniation and sciatica.
Herniation occurs when the disk’s soft center pushes out through a tear in the tough exterior. Herniated disks can cause sciatica, a condition characterized by pain in the back, hip, and part of the leg.
Conservative treatment options for herniated disks and sciatica include over-the-counter pain medications and corticosteroid injections. If these do not provide relief, a doctor may recommend removing the damaged disk and fusing the vertebra.
The team behind the new study used pulsed radiofrequency to treat a group of 128 people with herniated disks in the lower back. All experienced pain that had not responded to conservative treatments.
The researchers applied pulsed radiofrequency, under CT guidance, to each participant in a single session that lasted about 10 minutes.
“Pulsed radiofrequency creates a nerve modulation, significantly reducing inflammation and its associated symptoms,” stated Dr. Alessandro Napoli, Ph.D., the study’s senior author and a professor of interventional radiology at Sapienza University.
Another group of 120 matched participants instead received between one and three sessions of CT-guided steroid injection.
In the first year after treatment, the researchers found that the participants in the pulsed radiofrequency group experienced more significant improvements in pain and reduced disability scores, compared to the steroid injection group.
The authors noted a probability of perceived recovery in 95 percent of pulsed radiofrequency group participants, compared with 61 percent in the injection-only group.
The team’s findings demonstrate that pulsed radiofrequency may be an effective treatment for people with low back pain.
“Given our study results, we offer pulsed radiofrequency to patients with herniated disk and sciatic nerve compression whose symptoms do not benefit from conservative therapy.”
Dr. Alessandro Napoli, Ph.D.
The senior author also notes that this alternative technique delivers quicker results than other treatments, explaining, “Treatment lasts 10 minutes, and one session was enough in a large number of treated patients.”
He adds that participants experienced no side effects, and continues, “We learned that when pulsed radiofrequency is followed by steroid injection, the result is longer-lasting and more efficacious than injection only.”