What is a Pulsed Radiofrequency Stimulation (PRF)?
PRF is a treatment for nerve pain or localised pain in the body caused by irritation or malfunction of a nerve or sensitization of the pain system. It is performed in an operating theatre under light sedation by a pain specialist.
A special needle is inserted under x-ray guidance until it sits alongside the nerve that is to be treated. There are many nerves in the body that can be treated this way but those most commonly treated are the nerve roots as they leave the spine. Once in position the tip of the needle is very precisely and gently heated using radiofrequency impulses to readjust the disordered function of the nerve.
When is PRF used?
PRF can be used for a range of nerve pain problems especially if you have responded to a diagnostic block (such as a transforaminal nerve bock). When a diagnostic blocks fails to alleviate pain for a long period of time PRF may be recommended. PRF can lead to longer duration reduction in pain and other symptoms. It can be used for some forms of arm pain, leg pain, shoulder pain, headache and face pain.
You will have a light sedation for your procedure and will usually be lying on your front. When the needle is in the right place, small electrical impulses to the needle tip are used o check you get the right sensation in the right spot. You will be able to talk with the pain specialist who may ask you if you feel the sensation in the normal pain area. You may also notice twitching of muscles near the area being treated. After the PRF you may have local anaesthetic injected that numbs the area.
Most likely you will have a day procedure (you will be admitted to hospital and go home on the same day). The procedure takes between about 30 and 60 minutes. You will need to fast before your procedure so that you can have a safe anaesthetic. You will be advised about this and what to do with your medications before the procedure.
What should I expect?
PRF is a therapeutic procedure. It is intended to reduce your pain in the long-term. After the procedure you can expect some discomfort around the points on the skin where the needles were inserted. The duration of effect varies but typically lasts between 3 and 12 months. The procedure can be repeated if pain returns.
Are there risks involved?
PRF is a safe procedure. Occasionally patients report a temporary increase in pain after the procedure or altered sensation. You may also notice tiny scars at the procedure site. There is a very low risk of infection, bleeding or injury to other nerves that could potentially cause some weakness or numbness that usually resolves over time.
What happens next?
You will have a follow up appointment after your procedure. If your pain has resolved substantially or completely then you may only need to return if you pain comes back. If you haven’t had a complete response then further management for your pain will be discussed at this time. This may include medication, physiotherapy, clinical psychology or further procedures.
In the case of numbness, which has not gone away after 24 hours or any loss of control over bladder or bowel, you should contact Pain Matrix or attend your local Emergency Department.