Pulsed radiofrequency to dumb down treated nerve is becoming a useful adjunct to treating untenable pain CRPS states. Post hip fracture leg painv pain state left patient with VAS 6-7/10 with breakthru of 9/10. Following dropped to 3/10 – after 8 months went back to 6/10 and was repeated and then down to 2-3/10.
Saudi J Anaesth. 2017 Jan-Mar;11(1):83-85. doi: 10.4103/1658-354X.197366.
Ultrasonography-guided pulsed radiofrequency of sciatic nerve for the treatment
of complex regional pain syndrome Type II.
Choi YH et al
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5292859/
- 43 year old male with right hip pinning
- constant pain foot and ankle , calf – dorsum, lateral sole, and toes of his right foot and the posterior side of the calf
Procedure :
- “The sciatic nerve was identified under ultrasonographic guidance just above the bifurcation of the nerve at the popliteal fossa and the final location of the needle tip was close to the sciatic nerve in the popliteal fossa .
- A sensory stimulation test was performed.
- PRF was applied at a temperature of 42°C for 120 s and repeated 4 times.
- After the procedure, 0.3% ropivacaine (10 mL, mixed with triamcinolone, 8 mg) was injected to prevent peri-neural inflammation.”
Results
- Had to drag foot and use crutches
- pain was 3/10
- could be rehabbed
- 8 months pain returned an procedure redone
Comments – looks like any affected nerve could be done. This case CRPS had PRF and knee. Another case of ankle CRPS had it in superficial Peroneal nerve in shin:
Complex Regional Pain (CRPS) Dorsal Foot and Ankle- Dramatic Treatment and Could This Work in Forearm?- And New RX for Tennis Elbow
http://painmuse.org/?p=5021
The PRF duration was 2 minutes x4 = 8 minutes which is more than some.