New experimental treatment for chronic pain appears to provide significant relief in those with advanced degenerative arthritis.
Scientists have recently begun to treat chronic pain using electrical currents, produced by powerful radio waves, which “stun” certain nerves and slow pain signals on their way to the brain.
For those with arthritis of the knee, studies show that this type of nerve pain relief is better than steroid injections and appears to last up to a year in 65 percent of patients .
A small newspaper, presented at a recent conference, now suggests similar benefits to those with chronic hip and shoulder pain.
Today, radiofrequency ablation (RFA) is sometimes used to reduce pain caused by arthritis, but cooled radiofrequency ablation (CRFA) uses internally cooled probes to supply more of energy to the tissue, creating ulcers many times more and providing prolonged pain relief, as well as improved function.
Also no significant adverse side effects were found. Unlike surgery, the procedure is non-invasive, and unlike pain medicine, there is no risk of repeated use or dependence.
The research is still preliminary, but the authors say the results are “very impressive and promising.”
“The patients with shoulder pain had a reduction of pain of 85 percent, and an increase in function of about 74 percent,” Gonzalez said.
“In patients with hip pain, there was a 70 percent reduction in pain, and a gain in function of about 66 percent.”
The study included 12 patients with shoulder pain and 11 patients with hip pain, who had become unresponsive to the management of anti-inflammatory pain and steroid injections. A few weeks before the procedure, they underwent an anesthetic nerve block near the appropriate arthritic joint.
In the actual procedure, patients were moderately groomed and given a local anesthetic. A needle, approximately 50- to 150-millimeters long, was then placed at several target locations near the main sensory nerves.
When sliding an electrode through the needle, a pulse of electricity was delivered to the nerve for 1 and a half minutes, raising the tissue temperature up to 80 degrees Celsius.
Three months later, not only did the two groups self-report a significant reduction in their pain, they also reported an improvement in the dynamic function of their joint.
Today, in terms of joint arthritis, many patients choose surgery at a certain point, but for those who are poor surgical candidates or those who want to postpone surgery, treatments such as radiofrequency ablation may Cooling that provides continuous pain relief can be very helpful.
Especially as some studies suggest that cooled radiofrequency ablation outperforms other treatments, such as steroid injections, in terms of ongoing pain relief.
“This procedure is a last resort for patients who are unable to be physically active and who may develop narcotic addiction,” Gonzalez said.
“Until recently, there was no alternative for treating patients at the end of the arthritis pathway who are not eligible for surgery or are unwilling to undergo surgical treatment.”
The results have not yet been announced, but Gonzalez is already thinking about the next step. He suspects that the therapy can be used for much more than just osteoarthritis.
“We’re scratching the surface here,” he said. “We would like to explore the effectiveness of the treatment on patients in other settings such as trauma, fractures and especially in cancer patients with metastatic disease.”
The results were presented at the AGM Radiological Society of North America.