Pulsed Radiofrequency involves giving short pulses of radiofrequency waves (waves with a frequency of about 500,000 cycles per second, compared to the 60 cycles per second of standard electricity) twice a minute. This technique differs from standard radio frequency procedures in that the tissue is seldom brought up to temperatures above 42 degrees Celsius, a temperature which is less than that of Dallas during a heat wave. Temperatures this low does not damage the cells, so that pulsed radiofrequency works by a different mechanism than does regular radiofrequency. The precise mechanism is uncertain, although there is some evidence to suggest that pulsed radiofrequency toggles ionic channels in the nerve membrane on and off.
The great advantage to pulsed radiofrequency is that it’s safe, particularly for use around the dorsal root ganglion or for peripheral nerves, such as the suprascapular nerve. It is particularly useful in treating headaches from whiplash, in treating pain going down the leg from inoperable spinal stenosis, and for treating back, shoulder and groin pain.
The downside of pulsed radiofrequency ablation is the limited amount of literature supporting its use. In an age of evidence-based medicine, more insurers are demanding documentation from research that new procedures have proven effectiveness. In the absence of such literature, reimbursement can be difficult to obtain. Vigorous efforts are underway to prove the effectiveness of pulsed radiofrequency.