Compared with the use of a standardized exercise program alone, the addition of radiofrequency denervation to a standardized exercise program did not lead to improvement in chronic low back pain among patients with pain originating from areas such as the facet joints, intervertebral discs or sacroiliac joints.
“The findings do not support the added value of radiofrequency denervation to a standardized exercise program to treat a subgroup of patients with chronic low back pain from resulting from anatomical structures, such as facet joints, sacroiliac joint and intervertebral discs,” Esther Maas, PhD, postdoctoral research fellow at Partnership for Work, Health and Safety, School of Population and Public Health, University of British Columbia, told Healio.com/Orthopedics. “Based on our findings, a standardized exercise program alone has to be the first choice in the treatment of these patients.”
Maas and colleagues studied three multicentered, non-blinded, randomized clinical trials with a total of 681 patients with chronic low back pain. Of these patients, 251 had with pain originating in the facet joints; 228 had pain from sacroiliac joints; and 202 had pain from a combination of these joints or intervertebral discs. Patients received either a 3-month standardized exercise program or radiofrequency denervation along with exercise. Three months after intervention, investigators evaluated participants for pain intensity. Other outcomes assessed at baseline, 3 months, 6 months, 9 months and 12 months included global perceived recovery, patient satisfaction, functional status, health-related quality of life, general health and chronic pain experiences. Investigators estimated the minimal clinically important difference in pain for all participants, which was defined as at least 2 points.
In the facet joint group, the mean difference between patients who received standardized treatment and those who received radiofrequency denervation was -0.18 at 3 months. This difference was -0.71 for patients in the sacroiliac group. Investigators noted the difference in the combination trial group was -0.99. – by Monica Jaramillo
Disclosures: Juch reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.