What is the role of radiofrequency therapy in the treatment of chronic pain?

Radiofrequency therapy uses controlled temperature to act on the ganglia, nerve trunks and nerve roots to coagulate and denature proteins, blocking the transmission of nerve impulses. It has been applied to pain treatment for more than seventy years, and through continuous improvement of the method, it can effectively treat certain pains in the head, neck, chest, lumbar and sacral areas (e.g. trigeminal neuralgia, cervicobrachial pain, posterior lumbar branch neuralgia, etc.). The goal of radiofrequency therapy is to reduce pain but preserve proprioceptive, tactile and motor functions. Compared with chemical nerve destruction therapy, it has the following features: (1) the size of the RF thermal coagulation injury can be precisely controlled; (2) the injury temperature can be precisely monitored; (3) the puncture needle can be accurately placed with the help of electrical stimulation test and impedance monitoring; (4) the same puncture needle can produce different types of crestal nerve injury; (5) RF treatment can be performed under general anesthesia; (6) multiple (6) Rapid recovery from thermal coagulation injury foci with fewer residual symptoms; (7) Low incidence of complications and side effects under normal operation; (8) If nerve conduction pathways are reopened and pain recurs, radiofrequency treatment can be repeated. Radiofrequency therapy is suitable for those who first perform diagnostic block with short-acting local anesthetics when conservative methods of pain treatment are ineffective, and who experience pain relief. It is most commonly used on the first level sensory neurons of the somatic sensory nerves, and these areas are safer to apply. The commonly used temperature is 60~80°C and the time varies from 30~300 seconds. Since continuous radiofrequency is a kind of temperature trauma to the tissue, its accompanying dangers include destruction of adjacent nerve tissue and long-term or permanent loss of sensory and motor function. in 1997, Sluijter (UK) proposed a new concept of pulsed radiofrequency, using short duration, high frequency (300~500kHz) radiofrequency with electrodes at the maximum temperature standard for destruction of nerves (£42°C) , the same purpose of treating pain is achieved. Studies have shown that in patients with refractory neuralgia, pulsed radiofrequency at the dorsal root ganglion or crestal nerve root can completely reduce or alleviate 90% of the pain, and after 7 months of follow-up, the post-treatment effect is still maintained.