Radiofrequency Treatment for Chronic Refractory Pain

Park, Jung Yul; Park, Dong Hyuk

Abstract

Radiofrequcy(RF) treatment has a long history, more than hundred years, for the management of chronic intractable pain of various causes. With better understanding of pain mechanism and advancement of technology, along with previous valuable experience, a simpler and safer method of delivering RF thermo coagulation to ideal sites are now available that can be expected to provide more beneficial effects to these patients with chronic disabling pain. This type of treatment will be especially helpful in aged in whom surgery is often contraindicated or highly risky due to medical problems. Here, using up-to-dated, evidence based knowledge and personal experience, authors have tried to introduce briefly the history and basic mechanism of RF technique and various clinical situations where this type of therapy is currently known to be indicated or effective in providing substantial pain relief. In summary, the RF thermocoagulation is proven to be effective way of providing significant pain relief in many chronic refractory pain states with numerous advantages such as minimal invasive, quantitative lesioning with temperature-controlled, well-circumscription of lesions, simplicity and feasibility of procedure, and most of all safety and cost-effectiveness. When it is selected based on careful investigation on type and cause of pain it can be expected to provide relatively long duration of pain relief and also to help to recover functional disabilities from such pain. However, judicious use is warranted because some painful conditions are known to be ineffective or contraindicated from this type of therapy and because there are possible serious complications, although very few. Use of latest technique of pulsed, high-frequency, low-temperatured thermocoagulation will possibly bring hope and new insights in the management of chronic intractable pain of neuropathic in nature. Further research and experience will be required before justifying this type of therapy in appling broader and more challenging situations.