Dr Anwar conducts a research study on the effectiveness of long-lasting RFA therapy in curing low back pain

 Chronic back pain, which is increasingly common and has a considerable economic impact, is a significant disabling factor. For the past decade, Radiofrequency Ablation (RFA) is a method that is frequently used to treat many kinds of chronic pain. Therefore, Dr Shahzad Anwar (Director, School of Pain and Regenerative Medicine, The University of Lahore (UOL)) along with fellow researchers conducted a research study to determine the long-term clinical outcomes of an RFA.

The study titled “Evaluation of Radiofrequency Ablation and its Comparison with Medial Branch Blocks in the Pain Management of Facetogenic Low Back Pain – a Two-year Follow-up Study” was published in the Journal of Fatima Jinnah Medical University (JFJMU). JFJMU is a peer-reviewed open-access journal owned and published by the Fatima Jinnah Medical University (FJMU), Lahore, Pakistan every quarter. 

The primary goal of the study was to determine the improvement in low back pain by using a visual analogue scale and physical impairment by using the Oswestry low back disability index scale. Patients were followed up till 2 years after the successful procedure. All the data was entered and analysed using SPSS 25.0.

Dr Anwar and his fellows conducted the randomised control trial from March 2019 to December 2021 at Iffat Anwar Medical Complex and the Department of Pain Medication at Azra Naheed Medical Complex. After taking the written informed consent the participants who were enrolled in the current study included: patients with low back pain for the past 2 years, both genders, age above 30 years and those who failed to respond to the previous treatments. After the radiological assessment, patients were randomised equally into two groups (Group A= Medial Branch Block, Group B= RFA) by using a computer-generated sequence. The grouping was followed by the evaluation of RFA and its comparison with medial branch blocks in the pain management of facetogenic low back pain.

The idea behind RFA for chronic pain is that the transmitting radiofrequency currents close to nociceptive pathways will block pain receptors. The nerves responsible for transmitting and/or modifying pain perception are the target of tissue damage caused by the thermal energy associated with radiofrequency ablation. Intra-articular facet injections and medial branch blocks are both thought to be more effective predictors of lumbar medial branch RFA success than sham techniques. RFA’s potential long-term effects as a therapy option have not been thoroughly investigated. Therefore, more convincing evidence is required to support RFA’s effectiveness in the lumbar spine.

For the results, a sample of 60 patients were selected. The mean age of the patients was 57.6+9.6 years, while 35 (58.3%) of the patients were between 56 and 75 years of age. In the study, 41 (60,0%) were females, including 21 (51.2%) in control and 20(48,.7%) in the intervention group. At 12th (week), 1.5 and 2 (years), 30%, 80%, 33.3%, and 90.0% of patients reported a reduction in pain with a significant difference (P-value < 0.05). The patients exhibited a long-term effect in terms of pain reduction after RFA therapy.

A significant number of people with lumbar spine pain benefit from the effective and long-lasting therapy of RFA of the lumbar medial branch. The lumbar zygapophysial joints when subjected to radiofrequency denervation result in long-term pain relief under normal clinical conditions. However, in a selected patient population, RF lumbar facet joint denervation appears to be more effective than placebo therapy. The researchers recommended that the future studies could be conducted focusing on improving the RF technique and assessing the psychological profile as part of the RF treatment selection process.

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