Osman Ayman M, El-Hammady Dina H, Kotb Mohamed M
Assiut University, Faculty of Medicine, Egypt.
Assistant professor of Upper limb, Hand and Reconstructive Microsurgery Unit, Orthopedic Department, Faculty of Medicine, Assiut University.
Pain Physician. 2016 Nov-Dec;19(8):E1181-E1187.
Radiofrequency (RF) treatment is a minimally invasive procedure that has been used for more than 3 decades in treating various chronic pain syndromes. Conventional (continuous) RF treatment occasionally results in worsening or even initiating a new type of pain. The use of pulsed radiofrequency (PRF), which has a non- or minimally neurodestructive neuromodulatory effect, serves as an alternative to conventional RF therapy in many medical situations.
To evaluate the effect of applying PRF for 6 minutes vs. thermal radiofrequency (TRF) for 90 seconds to the medial calcaneal nerve for treatment of chronic refractory plantar fasciitis pain.
Prospective comparative study.
Pain, Orthopedic, and Rheumatology and Rehabilitation Clinics of Assiut University Hospital.
Twenty patients with refractory chronic bilateral plantar fasciitis received PRF to the medial calcaneal nerve for 6 minutes for one heel and TRF to the same nerve on the other heel (as their own control) for 90 seconds. Numerical verbal rating scale (NVRS) at waking up from bed and after prolonged walking, and satisfaction score were used for assessment of studied patients at one, 3, 6, 12, and 24 weeks from the intervention.
All studied patients showed significant improvement in their pain scale after the intervention that lasted for 24 weeks; however, the PRF heels had significantly better pain scale and satisfaction scores at the first and third weeks assessments when compared to the TRF heels. Effective analgesia was achieved after one week or less after PRF compared to 3 weeks for the TRF (P < 0.001).
No randomization.
PRF to the medial calcaneal nerve is a safe and effective method for treatment of chronic plantar fasciitis pain. The onset of effective analgesia can be achieved more rapidly with PRF compared to TRF on the same nerve. Further randomized trials are needed to confirm the therapeutic effect and optimizing the dose of RF needed.Key words: Pulsed radiofrequency, thermal radiofrequency, medial calcaneal nerve, plantar fasciitis, plantar aponeurosis, visual analogue scale.
射频（RF）治疗是一种微创手术，已用于治疗各种慢性疼痛综合征30多年。传统（连续）射频治疗偶尔会导致疼痛加重甚至引发一种新的疼痛类型。脉冲射频（PRF）具有非神经破坏性或最小神经破坏性的神经调节作用，在许多医疗情况下可作为传统射频治疗的替代方法。
评估对跟内侧神经应用6分钟PRF与应用90秒热射频（TRF）治疗慢性难治性足底筋膜炎疼痛的效果。
前瞻性比较研究。
阿斯尤特大学医院疼痛科、骨科、风湿科和康复科门诊。
20例难治性双侧慢性足底筋膜炎患者，一只足跟的跟内侧神经接受6分钟PRF治疗，另一只足跟的同一神经接受90秒TRF治疗（自身对照）。在干预后1、3、6、12和24周，使用起床时和长时间行走后的数字语言评定量表（NVRS）以及满意度评分对研究对象进行评估。
所有研究对象在持续24周的干预后疼痛量表均有显著改善；然而，与TRF足跟相比，PRF足跟在第1周和第3周评估时疼痛量表得分和满意度得分明显更好。PRF治疗后1周或更短时间内实现有效镇痛，而TRF则需要3周（P<0.001）。
未进行随机分组。
对跟内侧神经进行PRF治疗是治疗慢性足底筋膜炎疼痛的一种安全有效的方法。与同一神经的TRF相比，PRF能更快实现有效镇痛。需要进一步的随机试验来证实治疗效果并优化所需的射频剂量。关键词：脉冲射频、热射频、跟内侧神经、足底筋膜炎、足底腱膜、视觉模拟量表
