Nerve therapy may ease sciatica

A new clinical trial has found that pulsed radiofrequency (RF) provides lasting relief from sciatica pain. The minimally invasive procedure uses a fine needle to heat nerve roots near the spine, disrupting the nerve and preventing pain signals from reaching the brain. The procedure takes about 10 minutes and is performed on an outpatient basis without general anesthesia. The standard of care for sciatica is a steroid injection, but the effects wear off over time and can cause damage to the body. In the clinical trial, 350 people with sciatica were randomly assigned to receive either steroids alone or steroids combined with pulsed RF. By the end of the year, 96% of the pulsed RF group had experienced an improvement in pain compared with 69% of those who only received steroids. About 68% of the pulsed RF group experienced complete pain relief, compared with 13% of the steroid group. Additionally, significantly fewer people treated with pulsed RF required further treatment, including surgery. The procedure could help people with sciatica avoid or delay back surgery. The study replicates the results of a 2017 clinical trial that showed pulsed RF plus steroids could be used to treat pain caused by pinched nerves. Pulsed RF is used more often in Europe than in the United States to treat sciatica, even though the procedure has been long approved by the U.S. Food and Drug Administration. A follow-up clinical trial is needed to test pulsed RF alone against steroids to see if the therapy would work on its own.