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An experimental new treatment for chronic pain appears to provide substantial relief in some of those with advanced degenerative arthritis.
Recently, scientists have begun to treat chronic pain using electrical currents, produced by powerful radio waves, which “stun” certain nerves and slow down pain signals directed to the brain.
For those with knee arthritis, studies show that this form of nerve pain relief is better than steroid injections and appears to last for up to a year in 65% of patients.
A small new paper, presented at a recent conference, now suggests similar benefits for sufferers of chronic hip and shoulder joint pain.
Today, radiofrequency ablation (RFA) is sometimes used to reduce pain caused by arthritis, but cooled radiofrequency ablation (CRFA) uses internally cooled probes to deliver more energy to the tissue, creating lesions many times larger and providing prolonged pain relief as well as improved function.
Furthermore, no significant negative side effects were found. Unlike surgery, the procedure is non-invasive, and unlike pain medications, there is no risk of repeated use or addiction.
The research is still preliminary, but the authors say the results are “very impressive and promising”.
“Patients with shoulder pain had an 85 percent decrease in pain and an increase in function of about 74 percent,” says Gonzalez.
“In the hip pain patients, there was a 70% reduction in pain and an increase in function of approximately 66%.”
The study consisted of 12 patients with shoulder pain and 11 patients with hip pain who failed to respond to anti-inflammatory pain control and steroid injections. A few weeks before treatment, an anesthetic nerve block was administered near the respective arthritic joint.
During the actual procedure, the patients were moderately sedated and subjected to local anesthesia. A needle, approximately 50-150 millimeters long, was then inserted into several target locations close to the major sensory nerves.
By sliding an electrode through the needle, a pulse of electricity was delivered to the nerve for 1 1/2 minutes, raising the temperature of the tissue up to 80 degrees Celsius.
Three months later, not only did both groups report a significant decrease in pain, but they also said they saw an improvement in the dynamic function of their joints.
Today, when it comes to joint arthritis, many patients opt for surgery at some point, but for those who are poor surgical candidates or those who want to delay surgery, treatments such as cooled radiofrequency ablation provide relief. from prolonged pain could be really helpful.
Especially since some studies suggest that cooled radiofrequency ablation works better than other treatments, such as steroid injections, when it comes to prolonged pain relief.
“This procedure is a last resort for patients who are unable to be physically active and may develop a narcotic addiction,” says Gonzalez.
“Until recently, there was no other alternative for the treatment of patients at the end of the arthritis pathway who do not qualify for surgery or are unwilling to undergo a surgical procedure.”
The results have yet to be published, but Gonzalez is already thinking about the next step. He suspects that the therapy can be used for much more than just osteoarthritis.
“We’re just scratching the surface here,” he says. “We would like to explore the effectiveness of the treatment on patients in other contexts such as trauma, amputations and especially in cancer patients with metastatic disease.”
The results were presented at the annual meeting of Radiological Society of North America.
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