Management of spinal pain : pulsed radio frequency versus steroid injection

Abstract

Background: Chronic pain is recognised as a major public health problem, producing a significant and economic burden (Dueñas et al., 2016). Further to this, chronic spinal pain can have an influence on the daily life of the individual (Dueñas et al., 2016). Therefore, relieving the pain symptoms and promoting recovery are two main goals that have gained attention. PRF and steroid injections are two methods used for the treatment of spinal pain, both having their strengths and weaknesses. The aim of this dissertation was to compare the efficacy of these two procedures in treating spinal pain. Research question: The research question used for this dissertation is; „Is PRF more effective than steroid therapy in patients with spinal pain?‟ The PICO elements are Population: individuals (adults) with spinal pain, Intervention: PRF, Comparison: steroid injection, Outcome: relief of pain. Inclusion criteria included: English language only, Systematic reviews, Meta-Analysis, RCT‟s, comparative studies, observational studies, Studies published from 2010 to 2018, studies involving all age groups, Studies involving all ethnic groups, Studies involving both genders, Studies involving spinal pain and pulsed radiofrequency, Literature reviews and “Peer reviewed studies”, “articles” and “academic journals”. Exclusion criteria included: Studies in languages other than English, Case summaries and case series, Studies involving pain in other regions than in spinal, Studies involving the subject Platelet Rich Fibrin (PRF), Studies not related to the subject, Studies published before 2010, Studies not related to pulsed radiofrequency, Studies on animals and studies having a sample size less than 30. Outcome of the search: This search resulted in six studies that where appraised, five being RCT‟s and one being a comparative study. These where appraised using the CASP tool. The results were inconclusive, however, those that favoured PRF where of the strongest according to the hierarchy of evidence, and where statistically significant when compared to those that favoured the steroid injection. Implications and recommendations: further studies need to be carried out, to clarify the efficacy that PRF has over steroid injections if any. Although PRF may not be more effective in pain relief then steroid injections, it comes with much less side effects then steroids do, thus still having more benefits over steroid injections.