Although many patients benefit from pulsed radiofrequency treatment, when the nerve or ganglion (a cluster of nerve cells) is treated by radiofrequency that is delivered in short ‘blasts’, there are still a lot of people who are unaware of pulsed radiofrequency. Yet within the ‘Pain World’ it is already being tried out not just to treat back, shoulder or leg pain, but increasingly its use is being seen as quite widespread and there are a number of new applications where pulsed radiofrequency treatment may be an efficient way of treating pain that is resistant to other traditional methods such as medication or nerve root blocks.
For example, pulsed radiofrequency is now regarded as one of the ways in which fibromyalgia can be treated. It is used for patients who have occipital neuralgia and it is even used for patients who have headaches, so it is increasingly being viewed as a much more ‘mainstream’ treatment for chronic pain, than it was a few years ago.
However, an interesting case was reported recently in http://www.hindawi.com/journals/prt/2010/963948.html, that details how pulsed radiofrequency was used to treat someone with post-traumatic stress disorder.
Stellate Ganglion Block
The procedure used was a stellate ganglion block. The stellate ganglion is a cluster of nerves that are referred to as the ‘sympathetic’ nerves. These nerves are generally not ones that transfer messages of pain, but instead, they control certain functions within the body such as our blood pressure, digestive system or even our heart rate.
Occasionally these nerves almost ‘flip’ and start sending out pain messages for reasons that we do not know. But when these messages are sent out then the body reacts in ways that we may not expect.
Post Traumatic Stress Disorder
Post traumatic stress disorder, sometimes referred to as PTSD, is a severe state of anxiety that follows an event whereby someone has felt that their life is in danger, the life of someone else is in danger, or there has been a significant threat to life.
It is often referred to as a ‘pathological anxiety’ and is a severe condition, which can leave patients in an extremely distressed state and there may be other feelings of depression, helplessness, reliving the experience and so on.
Generally this condition is treated with medication, psychotherapy etc. However, in the case documented, the patient had such extreme post-traumatic stress disorder that the pulsed radiofrequency treatment was administered as an alternative to the patient being admitted to a psychiatric hospital.
The day after the pulsed radiofrequency treatment the patient reported that he felt absolutely no anxiety but these returned, necessitating further radiofrequency treatments to block the stellate ganglion (the sympathetic nerves). The end result was that the patient did experience long periods where his anxiety was manageable, although it was not a permanent cure it should be recognised that PTSD is a complex condition and that it may well take several treatments to successfully reduce levels of anxiety.
Although this is not a definitive ‘cure’ for PTSD, it makes interesting reading and certainly leads us to believe that we are only just beginning to realise the full potential of pulsed radiofrequency treatment.