Individual research recommendation details

Recommendation ID

NG59/3

Question

Radiofrequency denervation:- What is the clinical and cost effectiveness of radiofrequency denervation for chronic low back pain in the long term?

Any explanatory notes
(if applicable)

Why this is important:- Radiofrequency denervation is a minimally invasive and percutaneous procedure performed under local anaesthesia or light intravenous sedation. Radiofrequency energy is delivered along an insulated needle in contact with the target nerves. This focused electrical energy heats and denatures the nerve. This may allow axons to regenerate with time, requiring the repetition of the radiofrequency procedure.
The length of pain relief after radiofrequency denervation is uncertain. Data from randomised controlled trials suggest relief is at least 6–12 months but no study has reported longer-term outcomes. Pain relief for more than 2 years would not be an unreasonable clinical expectation. The economic model presented in this guideline suggested that radiofrequency denervation is likely to be cost effective if pain relief is above 16 months.
If radiofrequency denervation is repeated, we do not know whether the outcomes and duration of these outcomes are similar to the initial treatment. If repeated radiofrequency denervation is to be offered, we need to be more certain that this intervention is both effective and cost effective.

Source guidance details

Comes from guidance

Low back pain and sciatica in over 16s: assessment and management

Number

NG59

Date issued

November 2016

Other details