In the management of chronic pain, the value of permanent nerve blocks was recognized. Surgical treatments of the peripheral nerves may cause neuroma (growth of tumor on nerve tissue) formation and deafferentation pain (pain which is continuous and has a burning sensation). After surgical alteration of the nerves, the symptoms may re-occur and then surgical methods may prove to be difficult. Three methods of nerve destruction are generally accepted :
- Injection of neurolytic substances are performed under X-ray and are suitable for the destruction of larger units like celiac plexus. The size of the injury or damage of an organ is very difficult to predict and the spreading of neurolytic substances may cause unwanted side effects.
- Cryoanalgesia or freezing of a peripheral nerve is more precise but its only disadvantage is the short duration which is usually three to six months.
- Radio frequency nerve destruction is a more definite technique which is based on the thermocoagulation of selected nerves using an electrode capable of accurate temperature generation.
Among the above mentioned techniques for treating pains, Radio frequency nerve destruction is widely used. It is a procedure in which special needles are used to create rift between selected nerves. The needles heat the nerve at a temperature of about 800. After 2 to 3 minutes, the heat projection is stopped resulting in the prevention of nerves from carrying pain signals. So what are the benefits or advantages of this procedure? They are as follows :
- Lesion or destruction of the nerves can be controlled without allowing damage to the nearby motor and other sensory nerves.
- Recovery period is rapid allowing patient to return to work or normal daily activity.
- The nerve destruction is usually long lasting which means that the process performed precisely will give pain relief for years.
- The destruction of nerve repairs without forming neuroma.
- There are very less chances of side effects and complications.
- This procedure can be repeated if pain re-occurs.
Like every surgical or non surgical procedure, Radio frequency nerve destruction has certain limitations :
- Pain control with nerve lesioning or destruction should not be regarded as an alternative of corrective surgical treatments.
- Patients who are suffering from psychological problems are not meant to undergo any sort of neuro-destructive pain control procedures. The reason is that such patients are likely to experience with pain and make complaints even if the procedure was a success.
- This procedure is actually meant for reducing the pain and not for stopping it.
- Patients with pain at multiple locations are likely to respond poorly to this procedure.
- Deafferentation pain might increase due to the destruction of the affected nerve. If the pain is of central origin such as spinal or higher, then destruction of the peripheral nerve may cause an increase in the process of pain perception.
This radio frequency lesioning and other similar non-invasive procedures are applicable in scenarios where it is not possible to perform surgery on a patient.
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