What is pulsed radiofrequency?
Pulsed radiofrequency is a minimally invasive procedure using fine needles to ‘stun’ the pain fibres responsible for your pain. Unlike radiofrequency ablation which aims to ‘destroy’ the pain fibres, pulsed radiofrequency attempts to ‘reset’ or ‘reboot’ the nerve using radiofrequency current, akin to resetting the computer in order to reduce the increased nerve sensitivity that might be responsible for your pain.
How do we use pulsed radiofrequency?
We can use pulsed radiofrequency for:
- Pinched nerve from bony spurs or herniated discs
- Spinal stenosis where there is a narrowing of the spinal canal
- Post-amputation pain
- Complex regional pain syndrome (CRPS)
- Pain in the face like Trigeminal neuralgia, Glossopharyngeal neuralgia
- Headache conditions such as Cluster Headache and Occipital neuralgia
- Post-herpetic neuralgia which is pain after “Shingles”
- Post-surgical neuropathic pain
- Pudendal Neuralgia
- Other neuropathies
How do you perform pulsed radiofrequency?
We will give you some sedation for the day surgery procedure. Routinely, we do this minimally invasive procedure using either X-ray or ultrasound guidance. We give a local anaesthetic to numb the skin and tissues around the target before placing a thin needle next to the target.
After that, the pain specialist will run a radiofrequency current to test if we placed the needle sufficiently close to the target nerve. You may feel a tingling sensation. After confirming the position, we use short bursts of radiofrequency energy to ‘stun’/’reset’ the nerve to provide pain relief. You should not feel any pain. As opposed to the traditional radiofrequency ablation, the nerve is not ‘destroyed’ and thus there is less risk of complications.
In total, we apply the pulsed radiofrequency for up to 10 minutes to each affected nerve, and the total time taken for the procedure will depend on the number of nerves to be treated. We usually give an injection of local anaesthetic and steroid after the pulsed radiofrequency treatment in order to reduce the nerve irritation.
After the procedure, we will monitor you for about an hour in the recovery room before you allowed to return home.
What are the risks of pulsed radiofrequency?
This is a very safe and minimally invasive procedure done as day surgery. The risks of infection, nerve damage and bleeding are very low. There may be a temporary increase in pain for up to 2 weeks, numbness and weakness, and unpleasant sensations. There will usually go away after a few days.
What should you do after the procedure?
You should not drive or engage in strenuous activities for 1 day. Resume normal activities the next day. A slow increase in activity can be attempted from the 3rd day onwards.
How effective is pulse radiofrequency?
Pulsed radiofrequency treatment can be life changing in terms of pain treatment. The effectiveness varies according to the patient and the condition being treated. We can repeat the treatment as required. Sometimes, patients may want to try a trial of a spinal cord stimulator if the pulse radiofrequency is effective but does not last long enough.