Farì Giacomo, de Sire Alessandro, Fallea Cettina, Albano Mariantonia, Grossi Gianluca, Bettoni Elisa, Di Paolo Stefano, Agostini Francesco, Bernetti Andrea, Puntillo Filomena, Mariconda Carlo
Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari, 70121 Bari, Italy.
Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", 88100 Catanzaro, Italy.
Diagnostics (Basel). 2022 Feb 26;12(3):600. doi: 10.3390/diagnostics12030600.
Radiofrequency (RF) is a minimally invasive procedure used to interrupt or alter nociceptive pathways for treating musculoskeletal pain. It seems a useful tool to relieve chronic pain syndromes, even if, to date, solid evidence is still needed about the effectiveness of this therapy. By this systematic review and meta-analysis, we aimed to evaluate the efficacy of RF in treating musculoskeletal pain. PubMed, Medline, Cochrane, and PEDro databases were searched to identify randomized controlled trials (RCTs) presenting the following: patients with chronic musculoskeletal pain as participants; RF as intervention; placebo, anesthetic injection, corticosteroid injection, prolotherapy, conservative treatment, physiotherapy, and transcutaneous electrical nerve stimulation as comparisons; and pain and functioning as outcomes. Continuous random-effect models with standardized mean difference (SMD) were used to compare the clinical outcomes. Overall, 26 RCTs were eligible and included in the systematic review. All of them analyzed the efficacy of RF in four different regions: cervical and lumbar spine, knee, sacroiliac (SI) joint, shoulder. The outcomes measures were pain, disability, and quality of life. A medium and large effect in favor of the RF treatment group (SMD < 0) was found for the shoulder according to the Visual Analogical Scale and for the SI joint according to the Oswestry Disability Index. A small effect in favor of the RF treatment group (SMD > 0) was found for the spine according to the 36-item Short Form Survey. Non-significant SMD was found for the other outcomes. RF represents a promising therapy for the treatment of chronic musculoskeletal pain, especially when other approaches are ineffective or not practicable. Further studies are warranted to better deepen the effectiveness of RF for pain and joint function for each anatomical region of common application.
射频（RF）是一种用于中断或改变伤害性通路以治疗肌肉骨骼疼痛的微创程序。它似乎是缓解慢性疼痛综合征的一种有用工具，尽管迄今为止，仍需要确凿证据来证明这种疗法的有效性。通过本系统评价和荟萃分析，我们旨在评估射频治疗肌肉骨骼疼痛的疗效。检索了PubMed、Medline、Cochrane和PEDro数据库，以识别呈现以下内容的随机对照试验（RCT）：以慢性肌肉骨骼疼痛患者为参与者；以射频作为干预措施；以安慰剂、麻醉剂注射、皮质类固醇注射、注射疗法、保守治疗、物理治疗和经皮电刺激神经疗法作为对照；以疼痛和功能作为结局指标。采用具有标准化均数差（SMD）的连续随机效应模型来比较临床结局。总体而言，有26项RCT符合纳入标准并被纳入系统评价。所有这些研究均分析了射频在四个不同部位的疗效：颈椎和腰椎、膝关节、骶髂（SI）关节、肩部。结局指标包括疼痛、残疾和生活质量。根据视觉模拟评分法，发现射频治疗组对肩部有中度和较大效果（SMD<0）；根据Oswestry残疾指数，对骶髂关节有中度和较大效果（SMD<0）。根据36项简明健康调查问卷，发现射频治疗组对脊柱有较小效果（SMD>0）。其他结局指标的SMD无统计学意义。射频是治疗慢性肌肉骨骼疼痛的一种有前景的疗法，尤其是在其他方法无效或不可行时。有必要进一步开展研究，以更好地深入了解射频对常见应用的每个解剖部位的疼痛和关节功能的有效性。
