What Is Pulsed Radiofrequency Treatment (PRF)?

During pulsed radiofrequency treatment, the nerves supplying a specific area are treated using a special needle that delivers electrical impulses in a pulsed (on-off-on-off) manner to improve the functioning of the nervous system. The exact mechanism of action is not fully understood, but changes in gene transcription within the nerves have been demonstrated, leading to the production of new types of proteins. The treatment temperature is 42°C, so it does not burn the nerves (in contrast to conventional radiofrequency treatment).

In Which Diseases/Conditions Can Pulsed Radiofrequency Treatment Be Used?

PRF treatment can be applied in various nerve-related conditions, so-called neuralgias, as well as other nerve disorders.

  • Ilioinguinal, iliohypogastric, genitofemoral, supraorbital neuralgia
  • Phantom pain
  • Post-amputation stump pain
  • Postherpetic neuralgia / nerve pain after shingles
  • Trigeminal neuralgia / facial nerve pain
  • Other

What Should Be Expected During Pulsed Radiofrequency Treatment?

The procedure is preceded by a diagnostic block, during which a small amount of lidocaine is injected near the nerve presumed to be responsible for transmitting the pain, temporarily disabling it. This allows the patient to test the expected degree of pain relief from radiofrequency treatment. The pain-relieving effect of radiofrequency treatment is similar to that of the diagnostic block.

What Happens After the Procedure?

  • Pain relief after the procedure can usually be managed with paracetamol or non-steroidal anti-inflammatory drugs
  • The patient can return to normal activities from the next day

How Long Can Improvement in Function and Pain Relief Be Expected to Last?

The duration of pain relief is variable and difficult to predict in advance. In some cases, it may last only 6 weeks, but often it can persist for years.

How Should the Patient Prepare for the Procedure?

The patient should not eat for 6 hours prior to the procedure, and may only consume water up to 2 hours before the intervention.
If the patient is taking any anticoagulant (blood thinner), they should consult their treating physician regarding possible discontinuation.

What Are the Possible Risks and Side Effects?

  • Infection
  • Persistence of pain, rarely temporary worsening
  • Nerve injury
  • Bleeding
  • Other specific risks depending on the treatment area, which will be explained by the treating physician

Source:

  1. Chua, N.H.L., Vissers, K.C. & Sluijter, M.E. Pulsed radiofrequency treatment in interventional pain management: mechanisms and potential indications—a review. Acta Neurochir 153, 763–771 (2011). https://doi.org/10.1007/s00701-010-0881-5