Radiofrequency-based treatment in therapy-related clinical practice – a narrative review. Part II: chronic conditions

Binoy Kumaran,Tim Watson

doi:10.1080/10833196.2015.1133034

Abstract

Background: Radiofrequency (RF)-based electrophysical agents (EPAs) have been employed in therapy-related clinical practice for several decades. They are used to reduce pain and inflammation and promote tissue healing. Although deemed less popular in current therapy practice, surveys suggest that some of these EPAs are still used reasonably widely.Objective: To review the evidence for the use of non-invasive low-frequency RFs (30 kHz - 30 MHz) for treating chronic therapy-related clinical conditions.Major findings: All relevant peer-reviewed clinical studies published in English, concerning low-frequency RFs were sought. Identified literature was stratified as ‘acute’ and ‘chronic’ based on their clinical area. The studies on chronic conditions were reviewed for this paper and analysed to assess the volume and scope of current evidence. Out of 120 studies identified, 90 related to chronic conditions. The majority of them (82 studies) employed shortwave therapy (SWT) in continuous (CSWT) or pulsed (PSWT) modes. Only eight studies employed frequencies other than shortwave. Overall 67 studies investigated conditions relating to ‘pain and inflammation’, 16 to ‘tissue healing’ and 7 studies to other less reported conditions.Conclusions: Evidence favouring and against RF-based EPAs is available. There is moderate evidence favouring the use of SWT (mainly PSWT) in knee osteoarthritis. Some evidence also exists for CSWT in chronic low back pain and PSWT for treating chronic wounds. Evidence for other conditions is insufficient and conflicting. A general lack of research emphasis in the non-shortwave RF band is evident. Further and wider research in this area is necessary.

Highlights

Therapeutic use of electrophysical energy has been well-established since the past century, making the treatment using electrophysical agents (EPAs) a key area in the realm of physiotherapy.[1,2]
Devices that employ radiofrequency electromagnetic field (RFEMF or RF) are a major component of EPAs, the use of which has been reported since the early decades of last century.[3]
Sixty-seven studies (74%) were conducted on conditions relating to pain and inflammation and 16 (18%) on conditions relating to tissue healing

Summary

Introduction

Therapeutic use of electrophysical energy has been well-established since the past century, making the treatment using electrophysical agents (EPAs) a key area in the realm of physiotherapy.[1,2] Devices that employ radiofrequency electromagnetic field (RFEMF or RF) are a major component of EPAs, the use of which has been reported since the early decades of last century.[3]The therapeutic effects of RF are mainly linked to their effects on pain relief and tissue repair.[4,5] These effects may be achieved either through thermal or through non-thermal mechanisms, which are essentially dose dependent.[5,6] At higher doses the cardinal effects of RF are heat-related physiological changes triggered by a rise in the tissue temperature.[7,8,9,10] At substantially lower doses of RF, a discernible rise in tissue temperature is not achieved,[7,8] but rather the absorption of RF energy in tissues instigate a modulation in cellular activity and alter membrane transport.[5]. Therapeutic use of electrophysical energy has been well-established since the past century, making the treatment using electrophysical agents (EPAs) a key area in the realm of physiotherapy.[1,2] Devices that employ radiofrequency electromagnetic field (RFEMF or RF) are a major component of EPAs, the use of which has been reported since the early decades of last century.[3]. Radiofrequency (RF)-based electrophysical agents (EPAs) have been employed in therapy-related clinical practice for several decades. They are used to reduce pain and inflammation and promote tissue healing. Objective: To review the evidence for the use of non-invasive low frequency RFs (30 kHz– 30 MHz) for treating chronic therapy-related clinical conditions. Major findings: All relevant peer-reviewed clinical studies published in English, concerning low frequency RFs were sought. The majority of them (82 studies) employed Shortwave Therapy (SWT) in continuous (CSWT) or pulsed (PSWT) modes. Some evidence exists for CSWT in chronic low back pain and PSWT for treating chronic wounds

Objectives

Methods

Results

Discussion

Conclusion