Neuropathic pain is usually the result of an injury or malfunction of the peripheral or central nervous system. Localised neuropathic pain is where the pain occurs in a specific nerve or trigger point.
The obturator nerve is the biggest nerve in the front lumbar plexus, which is a group of nerves in the lower back region. This cluster of nerves acts as a passageway for electrochemical signals that connect the brain to the abdomen, back, knees, and groin.
Pain, damage, and other problems of the obturator nerve can occur due to injuries to the nerve itself or to the nearby tissues and musculature. This may also be accompanied by entrapment, restriction, or impingement of the nerve.
Pulsed Radiofrequency Treatment
Pulsed radiofrequency treatment is a minimally invasive procedure in which the nerves that are causing pain are blasted with short bursts of radiofrequency waves. Unlike the traditional radiofrequency technique, which denervates the nerve with extreme heat to cause a permanent loss of sensation in the nerve, pulsed radiofrequency leaves no lasting damage. The nerves feel fine afterwards and are simply ‘retuned’ so that they no longer feel pain. For this reason, if it is deemed an appropriate treatment for the particular pain, pulsed radiofrequency is a preferred method of radiofrequency, allowing patients to undergo a very low risk procedure. It is effective, drug free and lasts for a couple of months.
Pulsed radiofrequency treatment is performed as an outpatient procedure at the London Pain Clinic, with patients free to leave as soon as the treatment has been administered. The area of nerve pain is located and is then sterilised with a chlorhexidine antiseptic spray. A fast acting local anaesthetic will be injected through a small cosmetic needle.
During the procedure, a catheter is fitted in the immediate vicinity of the affected nerve. The pulsed radiofrequency will then direct an electromagnetic field into the catheter, tricking the nerve into thinking that it is not experiencing pain, so that it no longer sends signals to the brain telling it so.
Some patients can experience pain with this procedure and some relate that their condition may be slightly more painful for a few days after treatment, but the nerve will then return to its natural state and the pain will effectively disappear.
The procedure will take around an hour. The patient may be anaesthetised or sedated to ensure that the catheter can be inserted and that there is minimal movement while the procedure is being carried out.
Many patients respond well to only one session of pulsed radiofrequency, so it could well be that only one session is required to alleviate the pain. However, patients react differently according to their own particular condition, what caused the meralgia paraesthetica in the first place and whether or not they have any other underlying medical conditions. However, most people will only require one or two sessions to experience significant improvement.