Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 153 (4), 763-71

Pulsed Radiofrequency Treatment in Interventional Pain Management: Mechanisms and Potential Indications-A Review


Pulsed Radiofrequency Treatment in Interventional Pain Management: Mechanisms and Potential Indications-A Review

Nicholas H L Chua et al. Acta Neurochir (Wien).


Background: The objective of this review is to evaluate the efficacy of Pulsed Radiofrequency (PRF) treatment in chronic pain management in randomized clinical trials (RCTs) and well-designed observational studies. The physics, mechanisms of action, and biological effects are discussed to provide the scientific basis for this promising modality.

Methods: We systematically searched for clinical studies on PRF. We searched the MEDLINE (PubMed) and EMBASE database, using the free text terms: pulsed radiofrequency, radio frequency, radiation, isothermal radiofrequency, and combination of these. We classified the information in two tables, one focusing only on RCTs, and another, containing prospective studies. Date of last electronic search was 30 May 2010. The methodological quality of the presented reports was scored using the original criteria proposed by Jadad et al.

Findings: We found six RCTs that evaluated the efficacy of PRF, one against corticosteroid injection, one against sham intervention, and the rest against conventional RF thermocoagulation. Two trials were conducted in patients with lower back pain due to lumbar zygapophyseal joint pain, one in cervical radicular pain, one in lumbosacral radicular pain, one in trigeminal neuralgia, and another in chronic shoulder pain.

Conclusion: From the available evidence, the use of PRF to the dorsal root ganglion in cervical radicular pain is compelling. With regards to its lumbosacral counterpart, the use of PRF cannot be similarly advocated in view of the methodological quality of the included study. PRF application to the supracapular nerve was found to be as efficacious as intra-articular corticosteroid in patients with chronic shoulder pain. The use of PRF in lumbar facet arthropathy and trigeminal neuralgia was found to be less effective than conventional RF thermocoagulation techniques.


Fig. 1
Fig. 1
Components of a PRF current in 1 s. λ wavelength of intrinsic RF current; f frequency of intrinsic RF current at usually 500 kHz; pw pulse width; x duration of each pulse cycle and therefore Pulse Frequency = 1/x

Similar articles

See all similar articles

Cited by 48 articles

See all "Cited by" articles


    1. Ahadian FM. Pulsed radiofrequency neurotomy: advances in pain medicine. Curr Pain Headache Rep. 2004;8(1):34–40. doi: 10.1007/s11916-004-0038-4. - DOI - PubMed
    1. Aksu R, Ugur F, Bicer C, Menku A, Guler G, Madenoglu H, Canpolat DG, Boyaci A. The efficiency of pulsed radiofrequency application on L5 and l6 dorsal roots in rabbits developing neuropathic pain. Reg Anesth Pain Med. 2010;35(1):11–15. doi: 10.1097/AAP.0b013e3181c76c21. - DOI - PubMed
    1. Al-Badawi EA, Mehta N, Forgione AG, Lobo SL, Zawawi KH. Efficacy of pulsed radio frequency energy therapy in temporomandibular joint pain and dysfunction. Cranio. 2004;22(1):10–20. - PubMed
    1. Benton HP, MacDonald MH, Tesch AM. Effects of adenosine on bacterial lipopolysaccharide- and interleukin 1-induced nitric oxide release from equine articular chondrocytes. Am J Vet Res. 2002;63(2):204–210. doi: 10.2460/ajvr.2002.63.204. - DOI - PubMed
    1. Bogduk N. Pulsed radiofrequency. Pain Med. 2006;7(5):396–407. doi: 10.1111/j.1526-4637.2006.00210.x. - DOI - PubMed