Pulsed radiofrequency in chronic pain

Purpose of review The increasing number of publications on pulsed radiofrequency (PRF) treatment of chronic pain reflects the interest for this technique. We summarize the literature for PRF in five indications: radicular pain, trigeminal neuralgia (TN), occipital neuralgia, shoulder and knee pain. Recent findings The efficacy and safety of PRF adjacent to the dorsal root ganglion was documented on cervical and on lumbar level. PRF has been used for the treatment of TN. The observed duration of effect is shorter than that of conventional radiofrequency, but no neurological complications are reported with PRF. PRF of the nervi occipitales is superior to steroid injections in occipital neuralgia. Several studies showed that PRF of the nervus suprascapularis may relief shoulder pain and can improve mobility of the shoulder joint. For the treatment of knee pain, different nerves have been targeted for PRF treatment. Summary PRF treatment has progressively gained a place in the management of chronic pain syndromes. The concept is appealing because long-lasting effects are reported without complications. Future research is needed with high quality randomized controlled trials and identification of the optimal parameters of PRF in clinical practice.