Comparison of the efficacy of continuous radiofrequency thermocoagulation, pulsed radiofrequency denervation applications, and TENS therapies for lumbar facet syndrome: A single-blind randomized controlled trial
Atilla Seçgin1
, Sibel Eyigor2, Can Eyigör3, Bora Uzuner4, İdris Şevki Köken5, Meltem Uyar3
1Department of Physical Therapy and Rehabilitation, Muş State Hospital, Muş, Türkiye
2Department of Physical Therapy and Rehabilitation, Ege University Faculty of Medicine, İzmir, Türkiye
3Department of Algology, Ege University Faculty of Medicine, İzmir, Türkiye
4Department of Physical Therapy and Rehabilitation, Ondokuz Mayıs University Faculty of Medicine, Samsun Türkiye
5Department of Algology, Balıkesir Atatürk City Hospital, Balıkesir, Türkiye
Keywords: Denervation, facet joint, low back pain, pulsed radiofrequency, radiofrequency thermocoagulation, transcutaneous electrical nerve stimulation.
Abstract
Objectives: We aimed to compare the effectiveness of TENS, used in physical therapy departments, and continuous radiofrequency thermocoagulation (CRF) and pulsed radiofrequency denervation (PRF), used in algology departments, in patients with lumbar facet syndrome (LFS).
Methods: Subjects were selected from patients with LFS visiting outpatient clinics of physical therapy and algology departments at Ege University School of Medicine, whose pain was refractory to medical treatment for at least 3 months. Subjects were randomized into 3 groups. A total of 60 patients, with 20 in each group, were enrolled. The first group received CRF, the second group received TENS for 30 minutes a day for 15 days, and the third group received PRF. Patients were assessed at baseline, at the end of the first and sixth months, for a total of three times.
Results: Improvements at month 1 and month 6 were found to be statistically significant in all three treatment groups with respect to their pain scores, Oswestry Disability Indexes, hand-floor distance measurements, 20-meter walking times, 6-min walking distances, Beck Depression Inventory, and most of the SF-36 domain scores (p<0.05). A comparison of the treatment groups showed no superiority of any group over the others in any assessment parameters (p>0.05).
Conclusion: We suggest that it might be more appropriate to use TENS, a non-invasive treatment, before trying more invasive procedures like CRF and PRF in these patients. However, it has been stated that further studies involving a larger patient sample are needed.