J Yeungnam Med Sci.  2022 Jul;39(3):200-205. 10.12701/jyms.2022.00101.

The mechanism of action of pulsed radiofrequency in reducing pain: a narrative review

• Park D
• Chang MC

• KMID: 2532072
• DOI: http://doi.org/10.12701/jyms.2022.00101

Abstract

Pain from nervous or musculoskeletal disorders is one of the most common complaints in clinical practice. Corticosteroids have a high pain-reducing effect, and their injection is generally used to control various types of pain. However, they have various adverse effects including flushing, hyperglycemia, allergic reactions, menstrual changes, immunosuppression, and adrenal suppression. Pulsed radiofrequency (PRF) is known to have a pain-reducing effect similar to that of corticosteroid injection, with nearly no major side effects. Therefore, it has been widely used to treat various types of pain, such as neuropathic, joint, discogenic, and muscle pain. In the current review, we outlined the pain-reducing mechanisms of PRF by reviewing previous studies. When PRF was first introduced, it was supposed to reduce pain by long-term depression of pain signaling from the peripheral nerve to the central nervous system. In addition, deactivation of microglia at the level of the spinal dorsal horn, reduction of proinflammatory cytokines, increased endogenous opioid precursor messenger ribonucleic acid, enhancement of noradrenergic and serotonergic descending pain inhibitory pathways, suppression of excitation of C-afferent fibers, and microscopic damage of nociceptive C- and A-delta fibers have been found to contribute to pain reduction after PRF application. However, the pain-reducing mechanism of PRF has not been clearly and definitely elucidated. Further studies are warranted to clarify the pain-reducing mechanism of PRF.

Keyword

Pain; Pain management; Pulsed radiofrequency treatment; Review

Figure

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  Fig. 1. The application of pulsed radiofrequency procedure on the lumbar dorsal root ganglion.

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  Fig. 2. The waveforms of continuous RF (CRF) and pulsed RF (PRF). While CRF is applied continuously without any resting phase, PRF has a long resting phase between brief electrical stimulation. RF, radiofrequency; Voltage, the amplitude of pulsed RF current.

Reference

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