Pulsed Radiofrequency: Procedure, Benefits, and Risks

Pulsed radiofrequency stimulation (PRF) is a well-established treatment for joint and nerve pain. The procedure differs from radiofrequency neurotomy (RFN) treatment where the probe is heated. Pulsed RF treatment applies an intermittent electrical pulse to the probe, thereby avoiding heating the nerve.

Pulsed RF can be used to treat:

  • Radicular pain (neuropathic pain from the spine)
  • Occipital neuralgia (pain in the back of the head or base of the skull)
  • Post-surgical neuropathic pain
  • Suprascapular nerve for shoulder pain
  • Medial branch nerves for facet joint spinal pain.

The average duration of pain relief is between four and 18 months, depending upon which nerve is being treated. However, pain relief may range from anywhere between four weeks to 26 months. In some cases, there is no benefit.

Like all procedures, PRF treatment carries some risks, including:

  • Allergic reaction to the medications used in the procedure or sedation is possible but can be treated on the day: nausea is not uncommon following sedation.
  • Infection is extremely unlikely with the possibility minimised using sterile techniques in an operating theatre. The needles are all disposable.
  • Occasionally patients may experience 1 – 2 hours of numbness or weakness of the leg after PRF of the dorsal root ganglion (DRG). This is quite normal and due to local anaesthetic leaking on the nerve. It always recovers once the anaesthetic action has warned off.

Generally, you will be discharged from the hospital within two hours and may resume normal activities on the following day. Simple analgesics are often required for a few days. If you’ve been using stronger analgesics, you may require stronger analgesia for a few days.