Radio frequency against chronic back pain
Back pain as a result of wear and tear
Increasing age, poor posture and physical load result in degenerative degradation processes in the area of the spine. In many cases, the intervertebral joints (facet joints) are also affected and can thus be the source of chronic neck and back pain. Unfortunately, a large part of the Swiss population is affected by this problem, which cannot always be treated satisfactorily with physiotherapy and pain medication (e.g. cortisone injections). Radiofrequency, as a minimally invasive therapy option, may contribute decisively to the improvement of pain control and ultimately to the quality of life of the affected patients. In many cases, not only can the amount of painkillers be reduced, but back surgery also postponed or, in some cases, even completely avoided.
How does radiofrequency treatment work?
Radiofrequency treatment is used in various medical fields worldwide and is an important therapy option especially in pain medicine. The target structures of the radiofrequency treatment are small nerves (medial branch nerves) that supply the painful facet joints. These medial branch nerves are specifically sclerosed by radiofrequency. A special radiofrequency cannula is placed at the medial branch nerve in a minimally invasive way, controlled by X-ray or ultrasound. Subsequently, a radiofrequency current is delivered to the nerve tissue via this cannula. Locally, heat is generated, which leads to the obliteration of the medial branch nerve.
Prerequisite: Positive test injections
At the IISZ, radiofrequency therapies are carried out according to the quality standards of the Spine Intervention Society (SIS). An important prerequisite to perform a radiofrequency treatment are two positive diagnostic test injections, which were previously performed in the area of the medial branch nerve to be treated.
Efficacy and duration of effect
If the indication is correct and the test injections are positive, radiofrequency treatment of the facet medial branch nerves usually leads to a significant pain reduction of 60 to 80% during 6 to 12 months. In the further course, the pain may return insidiously. In this case, the radiofrequency treatment can be repeated, usually with the same outcome.
Important factor of success: physiotherapy
A lasting effect of a successful radiofrequency treatment is decisively supported by a subsequent physiotherapy.
Side effects and complications
As with other pain medicine interventions / injections, side effects and complications are generally very rare. During the first 48 to 72 hours after radiofrequency therapy, disturbing local pain may occur, which soon fades away. The occurrence of complications from infections or bleeding is minimal with proper preparation. Irreversible nerve damage is extremely rare (<1:10'000).
Lord S.M et al., Percutaneous radiofrequency neurotomy for chronic cervical zygapophyseal joint pain: The New England Journal of Medicine: Vol 335 no. 23, pp. 1721 – 1763
Leggett LE, et al., Radiofrequency Ablation for Chronic Low Back Pain: A Systematic Review of Randomized Controlled Trials, Pain Res Manag. 2014. PMID: 25068973