Treatment Of Lateral Epicondylitis With Pulsed Radiofrequency: Comparative Study Of Two Procedures
|Bovaira M1*, Calvo A2, Jiménez A2, Jovaní M3, Desçe J2 and March R4|
|1 Head of Pain Unit, Department of Anesthesiology, Critical Care and Pain, Levante Rehabilitation Center, Valencia, Spain|
|2 Department of Anesthesiology, Critical Care and pain unit, Centro de Recuperación y Rehabilitación de Levante, Valencia, Spain|
|3 Associate Professor of Biostatistics, Valencia University of Medicine and Surgery, Valencia, Spain|
|4 Head of Anesthesiology, Department of Anesthesiology, Critical Care and Pain Unit, Levante Rehabilitation Center, Valencia, Spain|
|Corresponding Author :||Maite Bovaira Forner
Head of Pain Unit
Department of Anesthesiology
Critical Care and Pain
Levante Rehabilitation Center
Cirilo Amorós 47- 2º- 2ª 46004, Valencia, Spain
Tel: +34 649409017
E-mail: [email protected]
|Received January 17, 2014; Accepted February 07, 2014; Published February 09, 2014|
|Citation: Bovaira M, Calvo A, Jiménez A, Jovaní M, Desçe J, et al. (2014) Treatment of Lateral Epicondylitis with Pulsed Radiofrequency: Comparative Study of Two Procedures. J Pain Relief 3:132. doi: 10.4172/2167-0846.1000132|
|Copyright: © 2014 Bovaira M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
Objectives: Lateral epicondylitis (tennis elbow) is a tendinosis of the forearm extensor muscles; it has a clear occupational profile. Epicondylitis usually improves with conservative treatment but some 10% of cases require more invasive therapies, such as shock waves, infiltration with steroids or growth factors. Although its mechanism of action is unknown, pulsed radiofrequency appears to improve the patient’s perception of pain. In recent years, this has been used in peripheral pathologies with promising results. This study evaluates the efficacy of two different patterns of radiofrequency for treating epicondylitis.
Materials and methods: This was a comparative study of 34 patients, divided randomly intotwo groups: Group A received pulsed radiofrequency (PRF) at the lateral epicondyle trigger point with two needles (45 volts, for four minutes), creating a dual field; whenever a trigger point was located at the exit of the posterior interosseous, PRF was applied for two minutes; Group B received PRF at the lateral cutaneous branch of the radial nerve for 4 minutes; whenever a trigger point was located at the exit of the posterior interosseous, PRF was applied for two minutes. All patients were monitored during a six-month follow-up.
Results: In general, there was a tendency for pain to decrease, but the visual analogical scale(VAS) identified significantly higher decreases in Group B than Group A. Group Atreatment was effective (VAS decreased more than 50%) for 23% of patients after one month, for 47% of patients after three months and 58.8% of patients after six months. Group B results were better, with decreases in pain experienced by 65% of patients after one month, and 82.3% of patients after three and six months. The recovery of strength was also greater in Group B (8 out of 10) than Group A (6 out of 12). The average time passed before Group A patients could return to work following treatment was 3.058 ± 2.4, and 1.176 ± 1.24 months for Group B patients.
Conclusions: When epicondylitis fails to respond to conservative treatment, pulsedradiofrequency is a safe, partially effective technique. Its effect is greater when it is applied to peripheral nerves than to trigger points.