If you’ll pardon the pun, something that’s really making waves in the world of sciatica treatment across the pond is pulsed radiofrequency treatment, or PRF.
PRF is a new way of looking at the treatment of sciatica. It’s minimally invasive, and according to the Radiological Society of North America, shows real promise for people whose sciatica has not responded to other forms of treatment, such as medication or steroid injections.
PRF is not a new treatment for pain. It has been used to manage chronic pain conditions such as cervical radicular pain and trigeminal neuralgia since 1996. It is only recently that it has started to become known as a more mainstream treatment for sciatica.
Outpatient treatment is carried out under a local anaesthetic. After anaesthesia, an electrode is inserted into the base of the sciatic nerve, under the guidance of ultrasound or a CT scanner. Short pulses of radio frequency waves are transmitted into the part of the nerve which sends pain signals to the brain. This energy alters the way that the pain signals are sent to the brain, disrupting them or reducing them to the point that the patient is no longer suffering discomfort. Patients start feeling the benefit around four to six weeks after treatment has started.
Because the radiofrequency waves are transmitted around the body, it does mean that PRF is not available for people with pacemakers or any other sort of implanted transmission device such as a spinal cord stimulator. It should also be used with caution in those taking blood thinners, such as warfarin. Side effects from this sort of treatment are usually rare, and it’s regarded as a low-risk treatment.
A trial was carried out by Sapienza University in Rome, comparing treatments on two groups of patients with sciatica. Group 1 received ten-minute sessions of PRF and steroid injections, and group 2 received the injections only. The result showed that 95% of group 1’s patients felt that they were starting to recover from sciatica, with less pain and more mobility, while group 2’s patients only cited a 65% improvement.
If you’re suffering from sciatica, and the usual conservative methods of treatment haven’t helped, PRF is certainly worth considering as an alternative to the far riskier surgical options.