Promising Treatment Found Ineffective for Discogenic Back Pain

About 39% of patients with chronic low back pain have problems that arise from the disc in the spine. Doctors call this condition discogenic back pain. In an earlier study, these authors found that patients were helped by a technique called percutaneous intradiscal radiofrequency thermocoagulation (PIRFT). PIRFT involves putting a needle directly into the painful disc and then using a set radiofrequency for a specific amount of time. The idea is that the heat inside the disc will build up enough to stop the nerves around the disc from sending pain impulses.

This study was designed to test the effectiveness of PIRFT. Researchers chose 28 patients with specific symptoms of discogenic pain in the low back. All patients were tested for pain levels using two different scoring systems, and they filled out a form about their functional abilities. The patients were divided into two groups. The treatment group received a specified PIRFT treatment. The control group got a fake treatment.

The authors then followed up on the patients' symptoms after treatment. Success was based on whether patients showed at least a 50% improvement in their scores on the first pain questionnaire and if they had at least a two-point drop in pain on the other system.

Eight weeks after treatment, only one patient in the treatment group had a successful result, compared to two patients in the control group. At eight weeks the two groups had no real difference in their pain levels or functional abilities.

Unlike the earlier study, this new research suggests that PIRFT treatment is not helpful in treating discogenic low back pain. However, the authors note that PIRFT might have been successful if the technique had been done differently or if it had been done only in patients with certain types of symptoms. They conclude that more research is necessary to determine the role of PIRFT in treating low back pain.

Gerard A.M. Barendse, MD, et al. Randomized Controlled Trial of Percutaneous Intradiscal Radiofrequency Thermocoagulation for Chronic Discogenic Back Pain: Lack of Effect From a 90-Second 70 C Lesion. In Spine. February 1, 2001. Vol. 26. No. 3. Pp. 287-292.

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