Pulsed Radiofrequency Versus Continuous Radiofrequency for Facet Joint Low Back Pain: A Systematic Review

To compare pulsed radiofrequency (PRF) treatment with continuous radiofrequency (CRF) to improve pain, functionality, and safety profile in patients with facet joint chronic low back pain. A systematic, critical review of recent literature was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Embase, Cochrane, Clinical Trials, and LILACS databases were searched. Medical Subject Heading terms were “low back pain,” “zygapophyseal joint,” and “pulsed radiofrequency treatment.” Original research articles in peer-reviewed journals were included in the review. The articles were thoroughly examined and compared on the basis of study design and outcomes. Only studies that met the eligibility criteria were included. Three randomized clinical trials comprising 103 patients (39 in PRF group, 44 in CRF group, and 20 in control group) were included in the final analysis. Two trials compared PRF with CRF, and 1 trial compared 3 groups: PRF, CRF, and control with intervention as conventional treatment. The studies reported greater pain control and better functionality with CRF compared with PRF. PRF showed a decrease in visual analog scale and Oswestry Disability Index in 2 studies, and 1 study reported increased pain and disability after the intervention. No side effects were reported. PRF treatment is less effective than CRF regarding pain control and return of functionality in patients with facet joint chronic low back pain. We recommend CRF with a large safety profile after conventional treatment.