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Pulsed or Thermal Radiofrequency for Back Pain?

Radiofrequency (RF) can be used to treat painful neck or back symptoms coming from the small joints along the back of the spine. These joints are called the facet joints. Used in this way, RF is a high-frequency alternating electrical current. RF can heat up and destroy tissue. When used this way, it is called thermal RF.

Thermal RF for the treatment of neck or back pain has some risks. It can cause inflamed nerve tissue. If the nerve to the muscles along the spine, the multifidus muscles, is destroyed, the spine can become loose, or unstable.

A new way to use RF is tried in this study. Doctors at the Pain Medicine Program from the Medical College of Georgia used pulsed RF instead of thermal RF. Pulsed RF doesn't heat up the tissue. It disrupts messages sent by the nerves without destroying them.

Pulsed RF is a painless treatment for neck or back pain when the problem is the facet joint. Used on 114 patients, more than half reported greater than 50 percent pain reduction. None of the patients had any problems with the treatment.

The authors report that pulsed RF is a safe and helpful treatment for joint-induced neck or back pain. The effects last up to four months, so the good effects are only temporary. The hope is that the joint will recover during this time. Patients will also have increased mobility and activity during the pain-free period.

References: Georgi Mikeladze, MD, PhD, et al. Pulsed Radiofrequency Application in Treatment of Chronic Zygapophyseal Joint Pain. In The Spine Journal. September/October 2003. Vol. 3. No. 5. Pp. 358-362.

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