Pulsed Radiofrequency Versus Continuous Radiofrequency for Facet Joint Low Back Pain: A Systematic Review.

OBJECTIVE: Compare pulsed radiofrequency treatment (PRF) with continuous radiofrequency treatment (CRF) to improve pain, functionality, and safety profile in patients with facet joint CLBP.

METHODS: A systematic and critical review of recent literature was conducted in accordance with the PRISMA guidelines. The sources of the data were PubMed, Embase, Cochrane, Clinical Trials, and Lilacs. The MeSH terms were: "low back pain," "zygapophyseal joint" and "pulsed radiofrequency treatment." Papers included in the review were original research articles in peer-reviewed journals. The articles were thoroughly examined and compared on the basis of study design and outcomes. Only studies that met the eligibility criteria were included.

OUTCOMES: Three randomized clinical trials (RCTs), with a total of 103 patients (39 in the PRF group, 44 in the CRF group, and 20 in the control group were included in the final analysis. Among the three trials, two compared PRF with CRF, and one trial compared three groups: PRF, CRF, and Control with intervention as conventional treatment. The studies reported greater pain control and better functionality with CRF compared to PRF. PRF showed a decrease in Visual Analogue Scale (VAS) and Oswestry disability index (ODI) in two studies, and one study reported increased pain and disability after the intervention. No side effects were reported.

CONCLUSION: The PRF treatment is less effective than CRF regarding pain control and the return of functionality in patients with facet joint CLBP. We recommend the CRF after conventional treatment with a large safety profile.