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Radiofrequency Therapy (RF): Treating Pain Caused by Trigeminal Neuralgia & Post Herpetic Neuralgia

Neuralgia is a sharp, shocking pain that follows the path of a nerve and is due to irritation or damage to the nerve. According to the National Library of Medicine, the two most common forms of neuralgia are post-herpetic neuralgia and trigeminal neuralgia.

While neuralgia is more common in elderly people, it may occur at any age. In this article, we’ll review Radiofrequency Therapy (RF) – a safe, highly effective treatment procedure for both trigeminal and post herpetic neuralgia.

About RF Therapy for Trigeminal & Post Herpetic Neuralgia

Pulsed radiofrequency (RF) therapy is used to treat these painful neuralgia conditions by interrupting sensory nerves which carry pain signals, a process known as lesioning. In general, radiofrequency therapy utilizes heat to interrupt nerve transmission with results lasting an average of 6-9 months.

Here are key points to keep in mind about Radiofrequency Therapy:

  • Pulsed radiofrequency follows the same principle, but instead heats at a lower temperature for a longer period of time – typically three minutes.
  • Pulsed RF uses radiofrequency current in short, high voltage bursts.
  • Because a lower temperature is utilized, pulsed radiofrequency lesioning may be preferable when sensitive body structures are located near the area to be targeted.
  • The procedure is less neuro-destructive, requires less local anesthetic, and results in fewer flares of pain.
  • In addition, a greater lesioning area is created with pulsed (RF) given the lower temperature and longer time period employed.

Beyond trigeminal and post-herpetic neuralgia, commonly treated conditions by RF also include low back pain secondary to facet joint arthropathies or sacroilitis and complex regional pain syndrome/reflex sympathetic dystrophy.

How is Pulsed Radiofrequency Performed?

Using x-ray (fluoroscopic) guidance, special needles are placed near the anatomical locations of the nerves to be targeted. When the needles are in place, electrodes are inserted through them and electrical testing is performed.

The first test verifies that the needle is close enough to stimulate sensory nerves. The second test confirms that the electrodes do not stimulate any motor activity of surrounding nerves. Motor stimulation would indicate the potential for possible motor weakness after the procedure.

Upon satisfactory motor and sensory testing, pulsed RF lesioning is initiated. Prior to lesioning a local anesthetic is administered for comfort during the procedure. During this time, the radiofrequency probe heats the nerve to a specified temperature, typically for three minutes.

What are the Expected Results of RF Therapy?

Pulsed Radiofrequency has been performed safely for many years with excellent outcomes. There may be mild post-procedural pain as the muscles and soft tissues which overlie the nerves have been disrupted during needle placement. These new pain symptoms typically subside within several days.

The majority of patients experience a significant decrease in their symptoms for 6 to 12 months, though some patients experience longer or shorter durations of relief. If you’re suffering from trigeminal or post-herpetic neuralgia and would like to learn if RF therapy is appropriate to resolve your pain, get started by requesting an appointment with one of our board-certified pain specialists.