PRF Treatment for Patients With Chronic Lumbosacral Radicular Pain Compared to Conventional Medical Management

Inclusion criteria

• Symptoms more than 3 months 18,48
• Optimized conventional medical management at least for 1 month
• Pain radiating into the leg, up to the hallux (big toe) (L5) or little toe (S1)
• The pain in the leg dominates over a possible lumbalgia, the average pain in the leg measured 3 times a day, at predefined time points, over 4 consecutive days prior to inclusion should be more than 5 (NRS 10-point scale) 8
• Pattern of radiation suggestive for L5 or S1 pathology 49,50
• One or more positive neurological tests of nerve root tension or neurological deficit 51 ; straight leg raising test (SLRT), contralateral SLRT, motor reaction during SLRT and passive cervical flexion, motor reaction during passive cervical flexion while bending forward in standing position
• Capable of understanding the information relative to the treatment and procedure and willing to provide informed consent
• Capable of understanding and filling-out the questionnaires necessary for evaluation of the treatments
• Patients having undergone low back surgery like discectomy with or without laminectomy are allowed to participate in the study

Exclusion criteria

• Patients younger than 18 years
• Malignant disorder or currently under treatment for a malignant disorder
• Previous lumbar fractures
• Proven myelum lesion or abnormalities in the central neurological structures
• Systemic or connective tissue diseases
• Diabetes mellitus type I
• Multiple sclerosis
• Coagulation disorders
• Pregnancy
• Conventional medical management less then 1 month
• Pain Catastrophizing Scale > 45. When the patient has a higher score he/she will first be referred to a psychologist for consultation 52
• Leg pain due to localized hip or knee pathology
• Patients with a pacemaker or neurostimulator
• Patients previously treated with RF or PRF of the lumbar DRG