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Radiofrequency denervation does little to ease low back pain, researchers say

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Deactivating the nerves offers little or no benefit for people with chronic low back pain, according to a study published in the medical journal JAMA.

Researchers carried out three randomised trials involving a total of 681 participants with chronic low back pain originating from the facet joints, sacroiliac joints, or a combination of these or the intervertebral disks.

The aim of the trials was to evaluate the effectiveness of radiofrequency denervation — a procedure in which nerve fibres are selectively destroyed by heat produced by radio waves and delivered through a needle.

All trial participants received a three-month standardised exercise programme and psychological support if needed. Participants in the intervention group also received radiofrequency denervation.

After three months, the researchers found that the trials assessing radiofrequency denervation for the sacroiliac joints and a combination of the facet joints, sacroiliac joints or intervertebral disks showed a statistically significant but not clinically important improvement in pain intensity.

There were no clinically important or statistically significant differences between the groups in the trial assessing radiofrequency denervation for facet joint pain.

The researchers concluded that, because patients saw little or no improvement in chronic low back pain compared with a standardised exercise programme alone, the findings do not support the use of radiofrequency denervation to treat chronic low back pain from these sources.

A limitation of the study was that, as the aim was to provide evidence of the added value of radiofrequency denervation in a multidisciplinary setting, as done in daily practice, participants and clinicians were not blinded, JAMA noted.