Transcutaneous radiofrequency: clinical experience

Introduction The pulsed through transcutaneous electrode radiofrequency TCPRFT was described previously in the literature in a range of anatomic sites Taverner et al reported on the beneficial effect of handling TCPRFT knee pain in patients awaiting surgery for joint replacement Subsequently published a series of cases in the management TCPRFT shoulder pain in patients Methods A retrospective study of patients was performed during the period diagnosed with knee pathology and chronic shoulder pathology We included in our study those patients referred for specialist diagnosed osteoarticular pathology shoulder and knee for more than three months duration after entering your conventional therapies performed ineffectively after handling conventional including steroid injections hyaluronic acid or ozone discarded for surgery All were treated as outpatients Patients receive treatments with a monthly interval between the two regardless of the evolution of his dolor En here is an initial study and a month pending realization of the other treatments The TCPRFT was performed with a radio frequency generator using Neurotherm NT modified leads connected to two channels in a surface mounted TENS adhesive and managed not termoacoplado mode with manual voltage Treatment was done always in the same position with two parameters pps msec V for minutes providing the electrodes as images Knee A nbsp nbsp nbsp Previous Position Suprapatellar medial lateral suprapatellar infrapatellar medial lateral infrapatellar B nbsp nbsp nbsp Rear Position popliteal fossa in four quadrants C nbsp nbsp nbsp Transverse transcutaneous Shoulder a nbsp nbsp nbsp acromioclavicular joint and deltoid insertion on the humerus b nbsp nbsp nbsp glenohumeral joint in the anteroposterior plane and subsequent behind the spine of the scapula deltopectoral the supraspinatus muscle Triangle D nbsp nbsp nbsp Same as above but a little more lateral delto pectoral Triangle and supraespoinoso muscle E nbsp nbsp nbsp Triangle delto pectoral and spine of the scapula F nbsp nbsp nbsp Articulacion acromioclavicular and under the root of the armpit After the patient s informed and assessment of VAS and SF agreement the above described technique is performed and weeks evaluates the patient again VAS and SF Results Study of patients aged mean years women and men is performed With unpeso comprised between kg on average all patients with BMI lt the most frequent diagnosis was knees and shoulder osteoarthritis muscle tendon injuries of patients were under treatment for opioid The temporal evolution of the disease in the patients was years In relation to the initial VAS was on average reducing to after month p lt in half of the patients the pain more than was reduced in of patients pain by in the first month period In relation to the physical activity of the patient is reduced increased activity occurs once the technical as well as non significant increase in secondary social activities and mood because shortly after evaluation of improvement a month Discussion the available evidence suggests that treatment with TCPRF probably work with an independent temperature path mediated by the changing electric fields Rapid changes in electric fields of sufficient amplitude produce forces Charged molecules that cause tissue distortion and disruption of the channel ion changing membrane potentials and altering cell function The effect of a high current density is unknown but the ionic movement result can be significant There is evidence that transmembrane potential induced can warp creating pores or break the membranes and disrupt synaptic signaling and A delta fibers C have been described changes in the lymph dorsal root RF following treatment the significance of this is incierto While electroporation is destructive to large electric fields fields may temporarily lower electric pores The latter may occur also quot conditioned low frequency stimulation quot of neurons which induces long term depression of synaptic transmission This electrical change can also lead to hyperpolarization of the cell In addition there may be an effect in the immune system unrelated to the electric field by reducing production of inflammatory cytokines IL beta TNF alpha and IL which in turn reduces the C reactive protein TCPRF therapy is a noninvasive treatment needle repeatable without pain clinic which requires no recovery sedation or anesthesia