Occipital Neuralgia: Treatment Using Pulsed Radiofrequency
The debilitating condition occipital neuralgia can be difficult to diagnosis and then to treat. The condition takes the form of very extreme headaches, which are often accompanied by other symptoms, including pain at the back of the eyes, light sensitivity and the scalp being ultra sensitive.
Conservative Treatments of Occipital Neuralgia
Conservative treatments relate to any treatments that are not invasive and in the case of occipital neuralgia, there are several conservative treatments available. These may take the form of intense massage, physiotherapy (often quite intensive), the application of heat, steroids and so on.
Treatment For Refractory Pain
Where the occipital neuralgia is refractory in nature, i.e. it does not respond to conservative treatment, then other alternative ways of treating the condition have to be explored.
One option is to treat the condition with a nerve block, where the occipital nerve points are effectively blocked from sending pain signals directly to the brain. This can often provide patients with relatively long lasting pain, but there are occasions where the pain returns or the procedure only awards short-term pain relief.
One option that may be considered at this stage is the use of pulsed radiofrequency which is sometimes abbreviated to PRF.
Pulsed radiofrequency has been in use for some years now, although its use is not incredibly widespread. It is a means whereby the nerves are effectively tricked into thinking they no longer feel pain: they are conditioned to feel as they did before they experienced pain. In effect they are ‘brainwashed’ into believing that they do not sense pain!
Pulsed radiofrequency is sometimes known as ‘cold’ radiofrequency. This is because it does not use heat to destroy any neurons in the same way that other radiofrequency methods may.
This makes the PRF treatment a less painful experience for the patient and so may be preferable to other treatments using radiofrequency.
How Pulsed Radiofrequency Works
Pulsed radiofrequency does not use heat, instead it is in effect a timed cycle that will deliver short pulses of energy (radiofrequency energy) to the nervous tissue around the nerve end.
This restores the nerve end to the state that it was in prior to feeling the pain, so it now stops signalling the brain that there is pain at this nerve end!
Use of Pulsed Radiofrequency
Early indications are that patients undergoing this procedure may actually have long term pain relief from this procedure(s). This could be up to one year, potentially more. Although its use is growing it is not readily available and it is not used by all pain consultants.
However, its use is preferred by some clinicians because it is a minimally invasive procedure that isn’t painful to the patient and furthermore, unlike true radiofrequency, it does not heat up and damage tissue so it is also minimally invasive on this front also.
There are some occasions where the use of pulsed radiofrequency is not advisable and its use will be advised, when deemed appropriate by your pain consultant who will be fairly sure that the procedure will be effective, prior to its being recommended.