Evaluation of the Efficacy of Ultrasound‐Guided Posterior Tibial Nerve Pulsed Radiofrequency Treatment in the Management of Diabetic Neuropathic Pain

Objectives To evaluate the efficacy of ultrasound (US)‐guided pulsed radiofrequency (PRF) treatment of posterior tibial nerve (PTN) in patients with painful diabetic peripheral neuropathy (PDPN) refractory to pharmacotherapy. Methods US‐guided PTN‐PRF treatment was applied for 240 s at a maximum temperature of 42°C with a pulse width of 20 ms in 55 patients with PDPN. The primary aim of this study was to evaluate the efficacy of US‐guided PRF treatment of the PTN on pain scores using a Visual Analog Scale (VAS) in patients with type 2 diabetes mellitus who had pharmacotherapy‐resistant PDPN. The secondary aims were to evaluate the impact of PRF on sleep quality using the Jenkins Sleep Scale (JSS), assess neuropathic pain severity using the PainDETECT Questionnaire (PDQ), and determine the incidence of procedure‐related adverse events. Results US‐guided PTN‐PRF provided effective pain reduction at both 1 and 3 months compared with baseline. The VAS score reduction rate was 62.5% at 1 month and 37.5% at 3 months post‐treatment. PTN‐PRF improved sleep disorders by providing pain control. The JSS score reduction rate was 43.75% at 1 month and 25% at 3 months after treatment. No procedure‐related adverse events were reported in any participants. Conclusion US‐guided PTN‐PRF treatment is an effective and safe method for pain control and sleep quality improvement in patients with PDPN refractory to pharmacological treatment.