Pulsed vs. Continuous Radiofrequency: Queens Doctors Explain Which Technique Works Best for Different Pain Types
When chronic pain disrupts your daily life, finding the right treatment approach becomes crucial. Two advanced radiofrequency techniques—pulsed radiofrequency (PRF) and continuous radiofrequency (CRF)—offer hope for patients seeking lasting pain relief. Understanding the differences between these procedures can help you make informed decisions about your treatment options.
Understanding the Two Radiofrequency Approaches
Pulsed radiofrequency (PRF) is unique in that it provides pain relief without causing significant damage to nervous tissue. PRF is aptly named because there are ‘silent phases’ in between current bursts, where heat is allowed to dissipate and the area cools down. This prevents the nerve and surrounding tissue from overheating past 40°C – the temperature threshold for causing damage.
In contrast, continuous radiofrequency (CRF) supplies high-frequency continuous current to the targeted nerves. The tip of the probe during the CRF procedure is at approximately 80°C and induces coagulative necrosis to target nerve structures around the probe tip. The normal device supplies continuous heat at around 85C to the nerve, while the pulsed device supplies ‘pulses’ of heat (generally at less than 40C) which minimises damage to the nerve.
How Each Technique Works
Research shows that PRF alters the way nerves function. The bursts of current “reset” the nerve to alter transmission of pain signals, therefore reducing pain. Resetting the nerve does not damage the nerve or cause worrying side effects. The mechanism by which PRF controls pain is unclear, but it may involve a temperature-independent pathway mediated by a rapidly changing electrical field.
Continuous radiofrequency works differently. A radiofrequency current is sent through the needle to heat the identified portion of the nerve. The current destroys that area of the nerve, stopping it from sending pain signals to your brain. This destructive approach creates lasting lesions that interrupt pain transmission.
Which Technique Works Best for Different Pain Types
The choice between pulsed and continuous radiofrequency depends largely on your specific condition and pain tolerance for potential side effects. PRF treatment is less effective than CRF regarding pain control and return of functionality in patients with facet joint chronic low back pain. However, pulsed radiofrequency can target the same types of pain as radiofrequency neurotomy, as well as some types of pain that radiofrequency neurotomy cannot treat. It also has fewer side effects than radiofrequency neurotomy (for example it rarely causes weakness or loss of normal sensation).
For patients seeking Radiofrequency Ablation Queens treatment, the decision often comes down to balancing effectiveness with safety considerations. For treating LFJ pain, cooled radiofrequency was the most effective, followed by thermal radiofrequency and then pulsed radiofrequency as the least respectively for the follow-up visit at 6 months.
Benefits and Considerations for Each Approach
Compared to traditional RF thermocoagulation techniques, PRF offers significant advantages such as ease of operation, high safety, minimal trauma, and fewer complications. Duration of pain relief can vary from patient to patient, with the range being 6-12 months and sometimes longer.
Continuous radiofrequency, while more aggressive, often provides longer-lasting results for certain conditions. RFA is considered for long-time pain conditions involving your spine after other methods, such as pain medication and physical therapy have not been successful.
The NY Spine Medicine Approach
At NY Spine Medicine, Dr. Douglas Schottenstein, one of the top pain management doctors in the country, leads the team to help patients get back to feeling strong, mobile, and confident faster than they ever thought possible. The core belief of their practice is that surgery should be a last resort for treatment of pain. They exhaust all possible medical options to help patients recover from their pain as safely and as painlessly as possible. Their holistic approach encompasses minimally invasive procedures to relieve pain, promote healing, and prevent future injury.
Double-board certified in neurology and pain management, Dr. Schottenstein brings extensive expertise to radiofrequency procedures. At NY Spine Medicine, they are dedicated to the treatment of pain and spine conditions and utilize the most advanced technology and treatment options available in a brand new, state-of-the-art facility.
Making the Right Choice for Your Pain
The decision between pulsed and continuous radiofrequency should always be made in consultation with experienced pain management specialists. It’s essential for patients to have a comprehensive discussion with their healthcare provider, including a pain specialist, to determine if facet RFA is a suitable treatment option for their specific condition. The decision to undergo RFA should be made in consultation with a healthcare team and consider an individual’s medical history and needs.
Both techniques offer valuable options for managing chronic pain, with pulsed radiofrequency providing a safer, less invasive approach for patients who may be candidates for repeat procedures, while continuous radiofrequency offers potentially longer-lasting relief for those who can tolerate the more aggressive treatment. Your pain management team will help determine which approach aligns best with your specific condition, pain tolerance, and treatment goals.