Cooled Radiofrequency Treatment for Radicular Pain Related to Lumbar Disc Herniation

Abstract

Background: Lower back and radicular pain are leading causes of disability and loss of quality of life, especially due to its high prevalence in the general population. Cooled radiofrequency treatment (CRT) has emerged as a novel non-invasive technique for the management of discogenic pain with safe and effective results. The aim of this study was to evaluate the effectiveness of CRT in the treatment of radicular pain secondary to a lumbar hernia in patients with chronic neuropathic pain after receiving conservative treatment that did not achieve adequate pain management. Methods: A prospective study of patients undergoing CRT for the management of discogenic low back pain was carried out. When attending the first evaluation and corroborating the lumbar hernias by magnetic resonance imaging (MRI), treatment was offered one month of physiotherapy before CRT. To assess the evolution of the patients, measurements were taken before and after the intervention with the visual analog scale (VAS) and the Oswestry low back pain disability scale (OLBPDS) scores. Results: A total of 74 patients (mean age: 48.42 ± 14.32 years, 66.11% female) were included, who were undergoing a total of 134 herniated intervertebral lumbar discs. When comparing the initial perception of low back pain and after finding a non-significant partial improvement with one month of physiotherapy treatment, it was observed that the patients who were offered CRT showed an average improvement in discogenic pain of 79.92% (p = <0.0001, 95% CI: -7.010 to -6.379) in 98.64% of cases. This was accompanied by an increase in their functionality of daily living activities, as measured by OLBPDS. No patients presented significant adverse events, and in the only case where the desired pain management was not obtained, the patient's discomfort did not worsen. Conclusions: Intradiscal biacuplasty by CRT is a considerable treatment for lumbar radiculopathy. Postoperative results demonstrated its effectiveness and safety in the management of radicular pain without the presence of significant adverse effects.

Exosomes for the Management of Low Back Pain: A Review of Current Clinical Evidence

“…Facet joints degenerate over time due to the secretion of inflammatory cytokines caused by age-related natural intervertebral disc degeneration, irregular body mechanics, and strains or trauma, leading to inflammation and pain and resulting in facet joint syndrome or spondylosis [6,11,12]. Disc herniation, defined as the bulging of the disc into the spinal canal, is another common cause of low back pain and results in compression of the nerve roots, leading to lumbar radiculopathy [13,14]. Existing treatment modalities for managing low back pain include non-pharmacological conservative modalities, such as physical therapy, acupuncture, and chiropractic care; pharmacological agents, such as oral narcotics and non-steroidal antiinflammatory drugs, and injections for medial nerve blocks consisting of local anesthetics and steroids; and minimally invasive procedures, such as radiofrequency ablation [2,6,15,16].…”