Management of refractory sciatic neuropathic pain using ultrasound-guided pulsed radiofrequency.

Abstract

Nowadays, pulsed radiofrequency (PRF) is being used to control several types of musculoskeletal pain. Herein, we report a successful application of ultrasound (US)-guided PRF for a patient with refractory sciatic neuropathic pain. We applied US-guided PRF to a 50-year-old man, suffering from refractory neuropathic pain on the left foot following sciatic neuropathy for a period of approximately 6 months. We performed PRF on the level of piriformis muscle because the lesion of the sciatic nerve was presented digitally from the level of piriformis muscle on the magnetic resonance images. Under US guidance, the catheter needle was placed close to the left sciatic nerve, and dysesthesia and tingling sensation were reported to be less than 0.2 V. The PRF treatment was administered at 5 Hz and 5 ms pulsed width for 360 seconds at 45 V. After PRF on the left sciatic nerve, pain intensity - based on a numeric rating scale - decreased from 8 to 2. The reduction of pain was sustained for at least 6 months after the PRF procedure. We concluded that the PRF treatment is a very useful treatment technique for patients with refractory sciatic neuropathy.