What is pulsed radiofrequency (PRF)?

Pulsed Radiofrequency therapy is a pain management intervention to provide long-term pain relief when the pain relief from nerve blocks have lasted only for a short period. PRF is the next step in the treatment protocol after a diagnostic nerve injection. It is unique in that PRF does not destroy the nerve completely but resets the pain nerve (i.e. Neuromodulation), to reduce pain and provides longer-term relief.

PRF is offered to patients with chronic pain originating from nerves.

What’s involved in the provision of PRF?

The radio frequency machine produces an intermittent (pulsed) electrical current through a needle which stimulates the nerve. The process should not be painful. It is a treatment that uses radio waves to control pain. A rapidly changing electric current is applied using a needle to a specific nerve which is causing problems. This causes changes to the nerve which can provide pain relief by preventing pain signals from reaching the spinal cord. Other signals from this nerve are not blocked.

During the procedure you will also be given a local anaesthetic and steroid injection to help relieve short term pain following the PRF.

What are the benefits?

PRF treatment can give long lasting pain relief for between three to18 months but everyone experiences the effects in a different way.

What are the risks?

Overall PRF injections are very safe and serious side effects or complications are rare. However, like all injection procedures there are some risks: Common risks include bruise or tenderness at the site of injection, an increase in your pain – this should only last a few days. Serious risks like infection, bleeding or nerve damage is rare.

What happens after an PRF?

You will be monitored for up to monitored closely in the recovery room for 30 minutes after the injection. When you are ready to leave, the staff will give you discharge instructions. You will need to keep a pain diary. It is important to maintain a diary to help the doctor ascertain the success of the RFA.

You may feel sore for one to four days. It may be due to muscle and nerve irritation. Your back may feel numb or itchy for a couple weeks. Maximum pain relief normally comes in two to three weeks but can take as long as six to eight weeks.

How long can I expect pain relief?

Your pain may or may not return after PRF lesioning which can range from 9 to 18 months. If it does, another RFA can be done.

How do I prepare for the procedure?

Please advise staff if you are:

1. Taking blood thinners (especially warfarin and clopidogrel)
2. Diabetic
3. Pregnant (or any chance of you being pregnant).
4. Allergic to iodine, betadine, shellfish, local anaesthetics, or steroids.
5. Unwell (especially if you have an infection)

Operating department staff may advise you to:

1. Fast
2. Take your usual medications (apart from those mentioned above)
3. Arrange for someone to accompany you home