Radiofrequency, analgesic technique in the treatment of pathology back

Written by: Dr. Fernando Torre Mollinedo
Edited by: Roser Bernés Ubasos

The spinal condition has increased its impact on modern society: the back and neck pain is a condition that affects 60% of the population at some point in life suffer low back pain.

Treatment involves lifestyle change, avoid sedentary lifestyle, exercise regularly within the possibilities of each person and maintain a healthy diet. But some of the people affected pain becomes chronic and can not be controlled with healthy habits, drugs or rehabilitation. It is in these cases when indicated more specific techniques such as radio frequency are in the hands of an expert in Pain Unit and as a prelude to more aggressive techniques such as surgery step.

The technique of Radio Frequency (RF) for the treatment of pain, involves passing a high frequency current (500,000 Hz) through a cannula, a needle is fully insulated except at the tip of 2 to 15 mm, the active part exert therapeutic action.

Back pain

Radiofrequency types of back pain

There are two clearly defined RF modes: Continuous Pulsed RF and RF.

• In Continuous Radiofrequency, passing the current through the cannula, the temperature thereof increases only in the active tip. The degree of control achieved voluntarily temperature (temperatures between 60-90 ° C are used), is therefore a technique in which neuroablativa thermocoagulation, ie by heat that the treated tissue is destroyed occurs.

• Pulsed In RF electrical current pulses is given, so that the cannula or not tissue is heated. The RFP interrupted by periodic current pulses to control the temperature and remove heat in the tissue (the highest temperature is 40-42 ° C in a time of 120 seconds). The advantage of pulsed radiofrequency is that is nondestructive so may be indicated on structures where conventional radio frequency can not be used, such as in nerve roots.


When radiofrequency treatment is necessary

It is recommended in patients with pain at the spine, and can be used practically at all levels of the spine: both cervical and thoracic and lumbar. It is very effective in cases of pain from involvement of nerve roots or radiculopathy, pain in the facet joints (which are the joints in the spine that connect one vertebra to another), pain from the disc degeneration thereof, or joint sacroiliac.

You can also use radio frequency on peripheral nerves as the suprascapular nerve in patients with pain or difficulty mobilizing shoulder. Syndromes and complex regional pain with pain maintained by the nervous system or the sphenopalatine ganglion for certain cases of migraine among many other uses for pain treatment.


Results of radiofrequency

Before performing radiofrequency treatment specialist Pain Unit makes a blockage in the area to be treated with local anesthetic and sometimes corticoid. The blockade is diagnosis, because if the pain disappears means it is a generating area of ​​pain and is also therapeutic because it relieves pain and removes for a while. Radiofrequency is superior to the blockade because its duration is much higher, 3 to 6 months or even a year. It is considered a success if the patient's pain decreases at least 50%, and this can be repeated after 6 months or a year without consequences for the patient.


Risks of radiofrequency

The technique in the hands of an expert in the Pain and following safety guidelines has few side effects. It is essential that the procedure is being performed in an operating room to maintain aseptic conditions and an accurate view under radiological control of the area that the cannula is inserted.

Other security measures would be checking sensory and motor stimulation one cannula is positioned and controlled radiologically. Before the radiofrequency should practice a stimulation parameters in which the patient perceives a tingling sensation in the area that usually has pain. This ensures that the cannula is in position. To confirm that there is a motor nerve, it is found to give a more powerful stimulation that no structure as arms or legs move. If instead it moves, it is a sign that should reposition the cannula.

As a physical art, there are the effects of the hassles of infiltration, which are minimal thanks to local anesthesia and sedation. Failure to control the insertion of the cannula, it could lead to undesired in another structure or a glass and causing a hematoma puncture.


Edited by Roser Berner Ubasos.

*Translated with Google translator. We apologize for any imperfection

By Dr. Fernando Torre Mollinedo
Pain Medicine

Dr. Torre is an expert in the treatment of pain. Specialist Anesthesiology 1994 is currently the Head of the Pain Unit at Quirón Bizkaia. His specialty is fibromyalgia, a disorder whose treatment has conducted several studies and investigations. His prestige is not only national, has since participated in numerous conferences abroad.

*Translated with Google translator. We apologize for any imperfection

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