Claims about pulsed radiofrequency for back pain and sciatica are premature

Our Review Summary

The main problems with this news release promoting an abstract from a radiology meeting are that it fails to mention the research is unpublished, and there are significant limitations which may well preclude a headline such as: “Pulsed Radiofrequency (pRF) Relieves Acute Back Pain and Sciatica.”

The touted benefits of pRF (pulsed energy applied to nerve roots of the spine by a probe) noted in this study are based on difficult-to-reproduce patient questionnaires, and framed with language that makes it very difficult for readers to place in an understandable context.

Although alternatives are nicely covered — benefits, costs, availability, and potential harms of the outpatient probe procedure are not.

We also reviewed a HealthDay news story about the study. Both the story and news release would have been improved with more discussion about cost, benefits and harms. Why This Matters

Chronic back pain that does not respond to conservative treatment, and sometimes includes shooting pain into the buttocks and leg (sciatica), is difficult to treat, a leading cause of disability, and poses a huge economic burden to both individuals and the health care system.

Although the search for treatments that are “minimally invasive” are well-intentioned and much needed, this catchphrase can be quite misleading. As we’ve written before , many readers erroneously equate “minimally invasive” with more advanced and effective, and involving fewer complications and recovery time. Rather than prey on this notion, releases should clarify if procedures touted in this way even come close to meeting such expectations.

Many back patients have very straightforward questions they need answered: Do I need surgery? If not, what are my alternatives? How effective are those alternatives? What are the benefits vs. risks involved? What will it cost me? Not answering those questions clearly (or making it clear if the answers are unknown) does readers a disservice.

Back pain creates tremendous personal, family and economic burdens. In the majority of individuals, the source of the pain cannot be identified, and undoubtedly there are many different causes of back pain. If the source of pain in any individual can be identified accurately, specific interventions may be able to be developed to treat that subset of patients resulting in improved quality of life for those individuals and less economic burden. But it’s also important to keep in mind that in the vast majority of individuals, the pain resolves spontaneously without any residual disability.

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