Jitsinthunun Thanawut, Li Caixia, Ng Tony Kwun-Tung, Zinboonyahgoon Nantthasorn
Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand.
Department of Anesthesiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, China.
Pain Physician. 2025 Nov;28(6):467-481.
Pulsed radiofrequency (PRF) is a neuromodulatory technique that has been widely used for pain management and has recently gained attention as a nondestructive alternative to conventional radiofrequency ablation (RFA), particularly for peripheral neuropathic pain. Over the past decade, PRF has been increasingly investigated for its potential benefits in various chronic pain conditions.
This review aims to summarize the fundamental principles, mechanisms of action, available evidence, and clinical applications of PRF in chronic pain management.
Narrative review.
A comprehensive literature search was conducted using PubMed, Scopus, and Google Scholar for studies on PRF published up to 2024. Key words included "pulsed radiofrequency," "pulse radiofrequency," "pulsed RF," and "pulse RF." Relevant case reports, case series, observational studies, randomized controlled trials (RCTs), meta-analyses, systematic reviews, and review articles were included.
PRF has shown promising results in managing various neuropathic pain conditions, particularly radicular pain and postherpetic neuralgia. Clinical evidence also supports its effectiveness in trigeminal neuralgia, occipital neuralgia, cervicogenic headache, chronic migraine, meralgia paresthetica, pudendal neuralgia, and coccygodynia, as well as musculoskeletal conditions such as knee osteoarthritis and shoulder pain. Emerging applications, including intraarticular and transcutaneous PRF, have demonstrated potential benefits. Adjusting PRF settings, such as high-voltage PRF, extended-duration PRF, and pulsed dose radiofrequency, may further enhance treatment effectiveness, though additional validation is needed.
This review is narrative in nature and not a systematic analysis. The included studies vary in quality, ranging from case reports to systematic reviews, depending on the availability of research for each condition. Additionally, significant heterogeneity exists in PRF methodologies, treatment parameters, and outcome measures, with a lack of standardized protocols contributing to variability in clinical outcomes.
PRF is a safe, non-ablative technique that modulates pain through electrical fields. It has demonstrated effectiveness in neuropathic pain, particularly radicular pain and postherpetic neuralgia. PRF offers long-term pain relief with minimal risks, though further research is needed to optimize its parameters and expand its applications in chronic pain management.
脉冲射频（PRF）是一种神经调节技术，已广泛应用于疼痛管理，最近作为传统射频消融（RFA）的非破坏性替代方法受到关注，尤其是在外周神经性疼痛方面。在过去十年中，PRF因其在各种慢性疼痛病症中的潜在益处而受到越来越多的研究。
本综述旨在总结PRF在慢性疼痛管理中的基本原理、作用机制、现有证据及临床应用。
叙述性综述。
使用PubMed、Scopus和谷歌学术对截至2024年发表的关于PRF的研究进行全面文献检索。关键词包括“脉冲射频”“脉冲式射频”“脉冲RF”和“脉冲RF”。纳入了相关的病例报告、病例系列、观察性研究、随机对照试验（RCT）、荟萃分析、系统评价和综述文章。
PRF在管理各种神经性疼痛病症方面显示出有前景的结果，尤其是神经根性疼痛和带状疱疹后神经痛。临床证据也支持其在三叉神经痛、枕神经痛、颈源性头痛、慢性偏头痛、股外侧皮神经痛、阴部神经痛和尾骨痛以及肌肉骨骼病症如膝关节骨关节炎和肩部疼痛方面的有效性。包括关节内和经皮PRF在内的新兴应用已显示出潜在益处。调整PRF设置，如高压PRF、延长持续时间PRF和脉冲剂量射频，可能会进一步提高治疗效果，不过还需要更多验证。
本综述本质上是叙述性的，而非系统分析。纳入的研究质量各异，从病例报告到系统评价不等，这取决于每种病症的研究可得性。此外，PRF方法、治疗参数和结局测量存在显著异质性，缺乏标准化方案导致临床结局存在变异性。
PRF是一种通过电场调节疼痛的安全、非消融性技术。它在神经性疼痛，尤其是神经根性疼痛和带状疱疹后神经痛方面已显示出有效性。PRF能以最小风险提供长期疼痛缓解，不过还需要进一步研究来优化其参数并扩大其在慢性疼痛管理中的应用。
