Chronic lower back pain has traditionally been treated with pain relievers, physical therapy and surgery. But new studies are showing promise for two alternative methods for treating back pain that are minimally invasive and don’t involve the use of drugs.
The first is cooled radio frequency (RF). In this procedure, radio frequency waves are used to produce heat on specific nerves surrounding the spine. The heat creates lesions around the nerves, destroying or reducing their ability to transmit pain signals to the brain. The patient remains awake during the procedure and is usually sent home afterwards.
In a study published in the journal Pain Medicine, researchers at the Carolinas Pain Institute and the Wake Forest Pain Center enrolled 59 patients who suffered with chronic low back pain for at least six months. Thirty of the patients were put in a control group and the remaining 29 were treated with Kimberly-Clark’s TransDiscal Cooled RF System.
The probe used in that procedure is cooled with circulating water, which moderates the temperature at the tip of the probe. The cooling helps the RF waves create large volume lesions without excessive heating.
After six months, patients treated with cooled RF reported significant improvements in physical function, and a decrease in their pain, disability and opioid use compared to patients in the control group.
“These data are particularly encouraging because there is now additional, compelling evidence to suggest a minimally-invasive approach, such as cooled radiofrequency, can provide sustained relief to a carefully selected group of patients,” said lead investigator Leonardo Kapural, MD, Clinical Director of the Wake Forest University Health Sciences Center Chronic Pain Center and the Carolinas Pain Institute.
“Patients treated with the TransDiscal Cooled RF System experienced clinically significant improvements in physical function compared to those in the control group.”
In the same edition of Pain Medicine, a second study found the use of cooled RF to be significantly effective for the treatment of low back pain. Austrian researchers examined the medical records of 126 patients treated with a similar Kimberly-Clark Cooled RF System.
After one year, two out of three of patients stopped or decreased their use of opioids; nearly half reported significant reduction in pain scores; and 85 percent stated their quality of life was improved or much improved.
“The promising results from these two studies further validate the effectiveness and role of cooled radio frequency as a minimally-invasive treatment option for low back pain,” said Lisa Kudlacz, General Manager of Global Interventional Pain Management, Kimberly-Clark Health Care. “Patients with difficult-to-treat, chronic low back pain have an option that has demonstrable benefits — reduction in medication usage, significant improvement in quality of life and improved functionality.”
“Mild” Procedure Effective after Two Years
Another minimally invasive back pain treatment known as the mild procedure remains effective after two years, according to a new study published in the Clinical Journal of Pain.
The mild procedure is designed to alleviate pain for patients suffering from lumbar spinal stenosis, which is caused by a narrowing of the spinal column due to age and wear. Stenosis compresses the nerves in the spinal canal, causing back pain and leg pain. Mild relieves the compression by restoring space in the spinal canal through an incision the size of a baby aspirin.
The mild study monitored 45 patients at 11 locations during a two year period and found statistically significant improvement in pain relief and physical function. Patient progress was documented at multiple times over the two year period, with patients reporting “major improvement” after just one week. The improvement continued with each subsequent follow-up.
Developed by Vertos Medical, mild is performed on an outpatient basis, does not require general anesthesia or stitches, and has a reported success rate of nearly 80 percent. The mild procedure was recently approved for use in Europe. Over 12,000 patients have received the treatment in the U.S. since it was approved by the Food and Drug Administration in 2008.
Degenerative lumbar spinal stenosis is a common disease of the lumber spine with symptom generally beginning at 50 to 60 years of age. As many as 1.2 million Americans may have it. Although not life threatening, it can severely limit activity and cause chronic pain.back pain, cooled radio frequency, mild procedure