Dr. Arcas Molina, a specialist in the Pain Unit, explains that there are two main causes of low back pain and pain radiating to the legs, which are “facet syndrome” and radicular or sciatic pain, respectively.
The facet syndrome has its origin in the arthrosis of small joints called “facets” that articulate some vertebrae with others (not all back pain comes from the disc). Radicular or sciatic pain has its origin in the entrapment or irritation of the nerves as they exit the spine, either due to a herniated disc or to degenerative stenosis of the spinal canal. Both pathologies can be improved by the application of radiofrequency therapy.
What does the treatment consist of?
It consists of the introduction of needles (by puncture through the skin with local anesthesia and a little sedation), which have at their tip electrodes that transmit a special electric current, which in the case of facet syndrome “burn” some small nerves that innervate these joints reducing the pain originated in them (Thermal Radiofrequency or Rhizolysis), and in the case of sciatica, “neuromodulate, do not burn” (Pulsed Radiofrequency) and reduce the pain signal that travels through the sciatic nerve without affecting the motor strength or sensitivity.
The procedure is performed with X-ray control, with the patient awake and does not require subsequent admission in most cases, and can then go home after a brief stay for observation.
What are the advantages of its application?
Radiofrequency prolongs in time the effect of a simple infiltration with local anesthetics and corticoids that would last only a few hours or a few days.
Is the pain relief immediate and how is it after the application?
- In the case of facet Sdme where Thermal Radiofrequency is used, there may be a transitory increase in pain during the first week, starting to improve after the first week.
- In the case of sciatic pain where Pulsed Radiofrequency is used, there is usually no transient increase in pain, but improvement may also begin after a week.
In what other pathologies can radiofrequency be applied?
The application of Thermal or Pulsed Radiofrequency has a wide range of possibilities: joint pain (shoulder, hip, knee), plantar fasciitis, peripheral nerve neuralgia (post-surgical pain, meralgia paresthetica), pelvic pain (pudendal neuralgia), headaches (Arnold’s neuralgia) and the dreaded Trigeminal Neuralgia.
When is it contraindicated?
In case of pregnancy due to lack of studies, patient with infection at the puncture site, blood coagulation disorders, and if the patient has a pacemaker, in which case it should be reprogrammed by the cardiologist beforehand.