Pulsed Radiofrequency Treatment: What Is the Evidence of Its Effectiveness and Should It be Used in Clinical Practice?

Pulsed radiofrequency (PRF) is a relatively new intervention derived from a well-established and proven intervention, thermal radiofrequency neurotomy (TRFN). Unlike TRFN, PRF does not destroy targeted nerves and surrounding tissue. Thus, if proven effective, PRF promises a safer, nondestructive approach than TRNF to various chronic pain conditions. This article addresses two questions. The first question is “What is the evidence that PRF is effective?” The short answer to this question is that the evidence is accumulating that suggests efficacy, and one new study, in review, appears to demonstrate efficacy. In the hands of European and American medical scholars, PRF has demonstrated a positive clinical effect in studies of algorithmically selected, consecutive samples of patients with sacroiliac joint pain, discogenic pain, lateral facet syndrome, and radiculopathy. These studies are described in articles accepted for publication in a peer-reviewed journal, Pain Medicine, that are appended to this article [1–4]. They suggest efficacy and the need for randomized controlled clinical trials of PRF to establish efficacy. A review of the extant literature in PRF by Cahana et al. is also appended [5]. A clinical trial of PRF with positive results was presented by Dr. van Kleef from his group in Maastrich, Germany, at the IASP in Sidney in August 2005, and is presently undergoing peer review for publication.