Pulsed Radiofrequency Neurotomy

What is Pulsed Radiofrequency Neurotomy?

Pulsed Radiofrequency Neurotomy (PRFN) is a non-destructive electrical treatment that can extend the benefit of nerve blocks. Unlike conventional Radiofrequency Neurotomy it does not damage nerves.

A nerve injection and PRFN can be performed through the same needle, adding no extra complications or risk to the nerve block in question. The PRFN may result in more prolonged benefits than a nerve block alone.

PRFN has been studied most in conjunction with epidural spinal nerve root injections for sciatica. It is thought to work by changing the way the nerve functions. In experimental settings, genetic changes that can have a prolonged effect nerve function have been observed.

PRFN is a controversial technique, without high quality evidence to prove it works. On the other hand, it is safe, adds no extra side effects to a planned nerve block, and may give more prolonged benefits than an injection alone.

The procedure:

PRFN is a day stay procedure.

The nerve block is performed (as it normally would be), under X-Ray or ultrasound guidance. The PRFN is performed at the same time through the same needle. The PRFN part of the procedure takes 3-4 minutes.

Your pain doctor may wish to talk to you to get “feedback” during the procedure, in which case the sedation will be kept at very low levels. The target nerve is stimulated electrically, and your doctor will ask for your “feedback” about what you are feeling. This can help confirm that the needle is in the correct position and that the stimulation corresponds to the area of pain being treated.

Giving “feedback” involves being only lightly sedated. As a result discomfort can briefly occur during needle placement. Some patients prefer not to give feedback – and have heavier sedation to reduce discomfort. This will be your choice to make (assuming heavier sedation is safe is safe for you).

After the injection.

The NIPM nurses will call you the morning after the procedure to assess your response and arrange follow up.

If you experience any severe pain, weakness or numbness, fevers or chills, severe headaches, bleeding /discharge from the wounds, or if you have any other concerns then please contact NIPM or the Day Hospital centre. If for some reason it is not possible to get in touch, please see your GP or attend your local emergency department for assessment.