Role of conventional and pulsed radiofrequency in treatment of low back pain and sciatica

Background: Low back pain is a feeling of discomfort, stiffness, or muscle tension below the costal border in the upper part of the back of the thigh, above the lower gluteal folds. Sciatica can occur with low back pain. The two most common techniques are pulsed radiofrequency (PRF) and conventional radiofrequency (CRF). Both techniques employ heat produced by particle vibration to cause a lesion. PRF employs intermittent high-frequency current injection to diffuse heat into nearby tissues and prevent temperatures from rising beyond 42 °C, known as the neuronal injury threshold. Aim of the study: To assess the efficacy of PRF and CRF applications across the pain and quality of life of persons with sciatica and low-back pain. Methodology: 50 patients were studied in the neurosurgical Department of Al-Azhar University Hospitals in Cairo, Egypt. Results: There was a significant decline in the rate of localized back tenderness after radiofrequency compared to before. There was a significant difference regarding Visual Analog Scale (VAS) for low Back Pain and lumber radicular ache which showed marked decrease after intervention with gradual increase in the following follow up periods. L4-L5 was the most spine level detected by MRI. Conclusion: We deduced from the results that PRF and CRF both effectively reduced sciatica and low back pain for the first three months, but that pain recurrence happened gradually and was shown by higher VAS scores at the six- and twelve-month follow-up visits.