Back pain and cervicalgia continue to challenge physicians.  It is not always possible to pinpoint the structure responsible for causing the pain and in some cases, even if identified, to provide appropriate treatment.  When causative treatment is not possible, and non-operative pain management measures fail, neurolysis via electrocoagulation of nociceptors is considered.  Radiofrequency (RF) —pulsed or continuous— is today the treatment of choice with high success rates and adverse event rates within acceptable limits. The following abstracts should provide the pain management specialists with the background needed to understand the benefits of RelēF Technology. Please click on the title to read the abstract.

1.      Abejon, D.; Garcia-del-Valle, S.; Fuentes, M. L.; Gomez-Arnau, J. I.; Reig, E.; and van Zundert, J.: Pulsed radiofrequency in lumbar radicular pain: clinical effects in various etiological groups. Pain Pract, 7(1): 21-6, 2007.

2.      Abraham, M. T.; Chiang, S. K.; Keller, G. S.; Rawnsley, J. D.; Blackwell, K. E.; and Elashoff, D. A.: Clinical evaluation of non-ablative radiofrequency facial rejuvenation. J Cosmet Laser Ther, 6(3): 136-44, 2004.

3.      Cahana, A.: Pulsed radiofrequency: a neurobiologic and clinical reality. Anesthesiology, 103(6): 1311; author reply 1313-4, 2005. (Abstract not available; reprints available upon request.)

4.      Cahana, A.; Van Zundert, J.; Macrea, L.; van Kleef, M.; and Sluijter, M.: Pulsed radiofrequency: current clinical and biological literature available. Pain Med, 7(5): 411-23, 2006.

5.      Cavanaugh, J. M.: Neural mechanisms of lumbar pain. Spine, 20(16): 1804-9, 1995.

6.      Cosman, E. R.; Nashold, B. S.; and Bedenbaugh, P.: Stereotactic radiofrequency lesion making. Appl Neurophysiol, 46(1-4): 160-6, 1983.

7.      Davies, P. W.; Luthardt, F.; and Staats, P. S.: Radiofrequency treatment in the United States. Pain Pract, 2(3): 192-4, 2002. (Abstract not available; reprints available upon request.)

8.      Fitzpatrick, R.; Geronemus, R.; Goldberg, D.; Kaminer, M.; Kilmer, S.; and Ruiz-Esparza, J.: Multicenter study of noninvasive radiofrequency for periorbital tissue tightening. Lasers Surg Med, 33(4): 232-42, 2003.

9.      Geurts, J. W.; Lou, L.; Gauci, C. A.; Newnham, P.; and van Wijk, R. M.: Radiofrequency treatments in low back pain. Pain Pract, 2(3): 226-34, 2002. (Abstract not available; reprints available upon request.)

10.    Hecht, P.; Hayashi, K.; Cooley, A. J.; Lu, Y.; Fanton, G. S.; Thabit, G., 3rd; and Markel, M. D.: The thermal effect of monopolar radiofrequency energy on the properties of joint capsule. An in vivo histologic study using a sheep model. Am J Sports Med, 26(6): 808-14, 1998.

11.    Higuchi, Y.; Nashold, B. S., Jr.; Sluijter, M.; Cosman, E.; and Pearlstein, R. D.: Exposure of the dorsal root ganglion in rats to pulsed radiofrequency currents activates dorsal horn lamina I and II neurons. Neurosurgery, 50(4): 850-5; discussion 856, 2002.

12.    Letcher, F. S., and Goldring, S.: The effect of radiofrequency current and heat on peripheral nerve action potential in the cat. J Neurosurg, 29(1): 42-7, 1968. (Abstract not available; reprints available upon request.)

13.    Lord, S. M., and Bogduk, N.: Radiofrequency procedures in chronic pain. Best Pract Res Clin Anaesthesiol, 16(4): 597-617, 2002.

14.    Organ, L. W.: Electrophysiologic principles of radiofrequency lesion making. Appl Neurophysiol, 39(2): 69-76, 1976.

15.    Raofi S, and SM., S.: Medication therapy in ambulatory medical care: United States, 2003-04. In Vital Health Statistics, pp. 1-40. Edited, 1-40, 2006.

16.    Riddle, D. L., and Schappert, S. M.: Volume and characteristics of inpatient and ambulatory medical care for neck pain in the United States: data from three national surveys. Spine, 32(1): 132-40; discussion 141, 2007.

17.    Rose, C.: Non-invasive monopolar radiofrequency for the treatment of tennis elbow: Outcomes of a prospective study. In preparation, 2009.

18.    Schaefer, S. L.; Ciarelli, M. J.; Arnoczky, S. P.; and Ross, H. E.: Tissue shrinkage with the holmium:yttrium aluminum garnet laser. A postoperative assessment of tissue length, stiffness, and structure. Am J Sports Med, 25(6): 841-8, 1997.

19.    Sluijter, M., and Racz, G.: Technical aspects of radiofrequency. Pain Pract, 2(3): 195-200, 2002.

20.    Vallejo, R.; Benyamin, R. M.; Kramer, J.; Stanton, G.; and Joseph, N. J.: Pulsed radiofrequency denervation for the treatment of sacroiliac joint syndrome. Pain Med, 7(5): 429-34, 2006.

21.    van Boxem, K.; van Eerd, M.; Brinkhuize, T.; Patijn, J.; van Kleef, M.; and van Zundert, J.: Radiofrequency and pulsed radiofrequency treatment of chronic pain syndromes: the available evidence. Pain Pract, 8(5): 385-93, 2008.

22.    Van Zundert, J.; Brabant, S.; Van de Kelft, E.; Vercruyssen, A.; and Van Buyten, J. P.: Pulsed radiofrequency treatment of the Gasserian ganglion in patients with idiopathic trigeminal neuralgia. Pain, 104(3): 449-52, 2003.

23.    Van Zundert, J.; Raj, P.; Erdine, S.; and van Kleef, M.: Application of radiofrequency treatment in practical pain management: state of the art. Pain Pract, 2(3): 269-78, 2002.

24.    Vatansever, D.; Tekin, I.; Tuglu, I.; Erbuyun, K.; and Ok, G.: A comparison of the neuroablative effects of conventional and pulsed radiofrequency techniques. Clin J Pain, 24(8): 717-24, 2008.

25.    Weiss, R. A.; Weiss, M. A.; Munavalli, G.; and Beasley, K. L.: Monopolar radiofrequency facial tightening: a retrospective analysis of efficacy and safety in over 600 treatments. J Drugs Dermatol, 5(8): 707-12, 2006.

26.    Whipple TL, Villegas D: Thermal and Electric Energy Fields by Non-invasive Monopolar Capacitive-Coupled Radiofrequency: Temperatures Achieved and Histological Outcomes in Tendons and Ligaments. PM&R. May 2010.

27.    Zelickson, B. D.; Kist, D.; Bernstein, E.; Brown, D. B.; Ksenzenko, S.; Burns, J.; Kilmer, S.; Mehregan, D.; and Pope, K.: Histological and ultrastructural evaluation of the effects of a radiofrequency-based nonablative dermal remodeling device: a pilot study. Arch Dermatol, 140(2): 204-9, 2004.

28.    Whipple TL: From Mini-Invasive to Non-Invasive Treatment Using Monopolar Radiofrequency: The Next Orthopaedic Frontier. Orthopedic Clinics of North America. 2009; 40(4): 531-535.