Cooled RFA Works for Sacroiliac Joint Pain

Chronic low back pain can make patients miserable. Much of that pain is in the sacroiliac region.

Reporting at the American Society of Interventional Pain Physicians, a University of Kentucky department of physical medicine and rehabilitation said Cooled Radiofrequency Ablation (CRFA) is a viable treatment option.

Justin Hare, DO and Vinod Muniswamy, MD, MPH and colleagues noted that “conservative treatments, such as lifestyle changes, physical therapy, bracing, anti-inflammatory medications, manual medicine options, steroid injections, and surgical fusion have shown variable degrees of success” in treating this common back pain, one that gets worse with age.

RFA has been used since 2001 but there have been concerns due to the variability of sacral lateral nerve branches. That can make it difficult for physicians to capture the target and maximize pain relief.

But CRFA can create larger lesions and thus ablate a bigger area, increasing the odds of deadening the pain-causing nerves.

The team surveyed the literature and found 39 studies of the technique and its efficacy in treating L5 posterior ramus and lateral sacral branches for sacroiliac joint pain, particularly its impact on function, pain and quality of life.

Of those studies, 17 matched criteria, though some were eliminated as being poorly designed.

Most of the studies showed that CRFA provided at least 50% pain relief for patients.

“Based on our review cooled RA could be considered as an alternative method of pain relief in sacroiliac joint pain and is an effective and safe choice with minimal side effects.” The team noted that there is also a need for better-designed randomized control studies to further investigate the topic.