Chronic pain involving the low back, neck, frozen shoulder, sympathetically mediated pain (reflex sympathetic dystrophy, migraine, trigeminal neuralgia) and peripheral neuropathic pain can be helped by using pulsed radiofrequency stimulation of the nervous system. The central theme of these painful conditions is the dysfunction of the nerves relating to the various body parts.

Example of frozen shoulder has dysfunction of nerves supplying the shoulder joint after acute inflammation of the shoulder capsule. Movement of the joint results in severe stretching of these sensitized nerves within the surrounding tissues. Neck or back pain may be sensitized nerves arising from disc protrusion or inflamed nerve roots secondary to compressed nerves.

Treatment usually include conservative measures such as local heat, traction, lumbar corset, anti-inflammatory medications (NSAIDS), muscle trigger point injections, acupuncture, physical therapy and manipulation.

Pulsed Radiofrequency Stimulation is likened to applying a laser on the sensitized nerves to stimulate recovery of the sensitized nerves. It does not generate any heat and is not harmful to nerves, when applied appropriately. The RFA is directed through a needle to the particular nerves or ganglion (nerve plexuses), under Xray guidance. It uses electro-motive forces to encourage increased mitochondrial activity and regeneration of axonal transport. Sensory and motor tests are then performed to ensure proper placement of the RF needle on the nerve. It allows for obliteration of pain and surrounding supporting structures (muscles) to recover. Once the pain cycle is broken, the original painful joint is rehabilitated under active physiotherapy.

There are occasions where RFA only partially reduces the pain, then the residual pain is usually coming from chronically damaged ligaments/tendons, dysfunctional sacroiliac joints or degenerated discs. Prolotherapy may be a helpful adjunct to therapy by strengthening ligaments/tendons and tightening the loosened or distorted joints. This then results in less pain and greater function. Periodic sacroiliac joint injection with steroids may also significantly reduce chronic sacroiliac joint pain.