Pulsed Radiofrequency Treatment Research Articles

Comparison of greater occipital nerve blockade with radiofrequency and steroid in chronic migraine

ObjectivesThe study aims to retrospectively compare steroid and radiofrequency treatments for the greater occipital nerve(GON) under ultrasound guidance in chronic migraine. MethodsMonthly average headache attack frequency, attack duration, visual analog scale(VAS) and the number of days analgesics were taken were recorded. Under ultrasound guidance, GON block was administered once a week for a total of four sessions. In the final session, 4 mg of dexamethasone was added to the local anesthetic for the steroid group (n:26). Pulsed radiofrequency (RF) treatment was applied to the RF group (n:25) just before the last session of the GON block. The pain course in the week following the procedure monthly average headache attack frequency, attack duration, VAS and the number of days analgesics were taken in a month were compared for both groups at 1–3–6 months. ResultsIn the first month, a statistically significant decrease in attack frequency was observed in the RF group. However, no statistically significant differences were found between the groups in other findings at different time intervals. A significant decrease headache attack duration,VAS, and the number of days analgesics were taken in a month was observed in both treatment groups. Both treatments were found to be effective, but the effect size of the treatment was higher in the RF group compared to the steroid group. ConclusionAlthough the results were better in the group receiving pulsed RF treatment, except for the attack frequency in the first month, no statistically significant superiority of one treatment method over the other was determined.

Comparing the efficacy and safety of high-voltage and standard-voltage pulsed radiofrequency for the treatment of postherpetic neuralgia: A pooled analysis from randomized controlled trials

Postherpetic neuralgia (PHN) is one of the most common and serious complications of herpes zoster infection. Pulsed radiofrequency (PRF) therapy has emerged to be a neuromodulation technique for the treatment of PHN. Two therapeutic options are available for PRF, including high-voltage and standard-voltage PRF. Some studies suggested that the former one had better clinical efficacy than the latter one. For the first time, this pooled analysis compared the efficacy and safety of these two surgeries for the treatment of PHN. Five commonly used databases were applied to identify the eligible studies. This study was registered on the PROSPERO (ID: CRD42023460236), which provided more relevant information. Finally, four randomized controlled trials (RCTs) with 285 participants were included. The combined odds ratios (OR) showed that high-voltage PRF exhibited a significantly higher treatment efficiency than the standard PRF (OR = 1.4, 95%CI: 1.16 to 1.69, P < 0.001). Additionally, the visual analogue scale (VAS) in the high-voltage PRF group was significantly lower than that of the standard PRF group at one week (SMD = −0.776, 95%CI: −1.408 to −0.145, P = 0.016), one month (SMD = −0.544, 95%CI: −0.907 to −0.180, P = 0.003), and three months (SMD = −1.096, 95%CI: −1.504 to −0.687, P < 0.001) after treatment, particularly at the three months after surgery. However, the VAS was comparable between the two groups (SMD = −0.94, 95%CI: −1.985 to 0.104, P = 0.077). Patients who underwent high-voltage PRF did not have a significantly higher incidence of adverse events than those with standard PRF (OR = 1.56, 95%CI: 0.78 to 3.13, P = 0.208). In summary, the current study revealed that high-voltage PRF is superior to standard-voltage PRF in improving analgesic efficacy in patients with PHN. Additionally, it does not increase the incidence of treatment-related adverse effects. Further studies are still warranted to determine the optimal voltage and duration of PRF treatment for patients with PHN.

Accuracy of augmented reality-guided needle placement for pulsed radiofrequency treatment of pudendal neuralgia: a pilot study on a phantom model.

Pudendal neuralgia (PN) is a chronic neuropathy that causes pain, numbness, and dysfunction in the pelvic region. The current state-of-the-art treatment is pulsed radiofrequency (PRF) in which a needle is supposed to be placed close to the pudendal nerve for neuromodulation. Given the effective range of PRF of 5 mm, the accuracy of needle placement is important. This study aimed to investigate the potential of augmented reality guidance for improving the accuracy of needle placement in pulsed radiofrequency treatment for pudendal neuralgia. In this pilot study, eight subjects performed needle placements onto an in-house developed phantom model of the pelvis using AR guidance. AR guidance is provided using an in-house developed application on the HoloLens 2. The accuracy of needle placement was calculated based on the virtual 3D models of the needle and targeted phantom nerve, derived from CBCT scans. The median Euclidean distance between the tip of the needle and the target is found to be 4.37 (IQR 5.16) mm, the median lateral distance is 3.25 (IQR 4.62) mm and the median depth distance is 1.94 (IQR 7.07) mm. In this study, the first method is described in which the accuracy of patient-specific needle placement using AR guidance is determined. This method could potentially improve the accuracy of PRF needle placement for pudendal neuralgia, resulting in improved treatment outcomes.

Comparing the effectiveness of pulsed radiofrequency treatment to lumbar dorsal root ganglion according to application times in patients with lumbar radicular pain: protocol for a randomised controlled trial

IntroductionLumbar radicular pain (LRP) is a common symptom characterised by a sharp, shooting or lancinating sensation localised to one or more dermatomes of the lumbar spine. Despite its high prevalence...

Evaluation of the efficacy of pulsed radiofrequency therapy in patients with lumbosacral radicular pain: An analysis of single-center data.

Lumbosacral radicular pain (LRP) is one of the most common causes of neuropathic pain. This pain often arises from inflammation in the dorsal root ganglia (DRG) or spinal nerves. Despite various treatment modalities, success rates are not very high in chronic LRP cases. Pulsed radiofrequency (PRF) therapy, frequently applied to the DRG, is widely used, but its effectiveness is often questioned in various studies. The primary aim of our study is to evaluate the effectiveness of PRF treatment in 154 patients. Patients with LRP for longer than 3 months, treated with PRF, were included in this study. To assess the efficacy of PRF treatment, numerical rating scale (NRS) scores were evaluated at the 4th-week and 6th-month follow-ups. The NRS scores were significantly lower at the 4th-week and 6th-month follow-ups compared to pre-treatment levels (p<0.001). However, there was no significant difference between the mean NRS scores at the 4th week and 6th month. Success in interventional pain procedures is often considered as at least a 50% reduction in pain scores. The success rate for PRF treatment for LRP in the literature varies between 30% and 60%, which is similar to our findings at the 4th week and 6th month. PRF treatment is widely used due to its low side-effect profile and cost-effectiveness in the long term. There is no fully standardized practice regarding procedural aspects, such as the duration of the application, and prospective studies with larger participation are needed.

Percutaneous pulsed radiofrequency ablation of articular nerves of the hip joint in patients with chronic hip pain refractory to conventional analgesics.

Total Hip Arthroplasty (THA) may be a risky proposition in patients with comorbidities, and they may require systemic analgesics for chronic hip pain (CHP). Since traditional pain medications may not provide complete pain relief or carry prohibitive adverse effects, pulsed radiofrequency (PRF) treatment of the hip articular nerves (HAN) has been proposed for effective clinical outcomes. We determined the efficacy of PRF-HAN in improvement in CHP compared to baseline pain on conventional systemic analgesics. Between August 2015 and December 2021, 31 adult patients with severe comorbid conditions and excruciating chronic hip pain were subjected to a PRF-HAN procedure following a diagnostic block. All 31 patients received PRF of the articular branches of the femoral and obturator nerves. Demographic parameters, numerical rating scale (NRS), Harris Hip Score (HHS), WOMAC scores, the change of these scores from baseline, and any adverse effects were recorded before treatment and on day 1, 1st week, 6 weeks, and 6 months after treatment. All the patients who underwent the PRF-HAN reported a significant improvement in NRS, HHS, and WOMAC scores compared to the baseline values on day 1, at the end of the 1st week, and the 6th week (p<0.001). No adverse events were documented in the study post-procedure until the end of 6 months. PRF-HAN is a strong alternative for chronic pain management and augments physical functioning and a return to daily activity in patients who would be deprived of arthroplasty considering associated comorbid conditions.

Efficacy and Safety of High-Voltage Pulsed Radiofrequency versus Standard-Voltage Pulsed Radiofrequency for Patients with Neuropathic Pain: A Literature Review and Meta-Analysis.

Neuropathic pain (NP) is recognized as one of the most difficult pain syndromes which lacks a safe, well-tolerated and effective treatment. Pulsed radiofrequency (PRF), a novel and minimally invasive interventions, has been introduced to alleviate various types of NP. Previous studies reported PRF with higher voltage could further improve the treatment efficacy. Therefore, we conducted this systematic review and meta-analysis to determine whether high-voltage PRF is superior to standard-voltage PRF for the treatment of NP patients. Databases published from the date of inception until 15 March 2022 on PubMed/MEDLINE, EMBASE, Web of Science and the Cochrane Library were searched for RCTs comparing high-voltage PRF and standard-voltage PRF in NP patients. The primary outcome measures were the efficiency rates of NP patients with high-voltage PRF or standard-voltage PRF treatment. Data analysis was conducted using the Review Manager software (RevMan V.5.3). Six RCTs involving 423 patients were included in our meta-analysis. Compared with standard-voltage PRF group, the high-voltage PRF group attained a higher efficiency rate at 1 month (P = 0.04; I2 = 0%), 3 months (P = 0.04; I2 = 0%), 6 months (P = 0.002; I2 = 0%) post-procedure respectively. There was no significant difference in the complications between the two groups. Our study supported that high-voltage PRF attained more satisfactory efficacy than standard-voltage PRF without increased side effects. High-voltage PRF could be a promising, effective, minimally invasive technology for NP patients.

Pulsed Radiofrequency Treatment in Patient with Lumbar Radiculopathy Due to Bertolotti's Syndrome: A Case Report

Pulsed Radiofrequency Treatment in Patient with Lumbar Radiculopathy Due to Bertolotti's Syndrome: A Case Report

Comparison of the Effect of Continuous Radiofrequency and Pulsed Radiofrequency Treatment on Third Occipital Neuralgia

Background: Third occipital neuralgia (TON) is an uncommon headache caused by C2-3 zygapophyseal joint osteoarthritis. Both continuous and pulsed radiofrequency have been used to treat TON. However, no studies have compared the effects of continuous radiofrequency (CRF) and pulsed radiofrequency (PRF) on TON. This study aimed to determine the most effective treatment for TON. Methods: A total of 61 patients were enrolled. CRF was performed at 80°C for 90 sec at three target lesions. During PRF, 42°C for 120 sec was applied to the target lesions. Numeric rating scale score (NRS) was assessed in all patients before treatment and at 2 weeks, 3, and 6 months after treatment. Successful treatment was defined as an NRS pain reduction of at least 50% at 6 months, as compared with the pretreatment score. Results: The mean post treatment pain scores at 2 weeks, 3, and 6 months were significantly lower in both groups. At 2 weeks and 6 months post-procedure, the CRF group showed significantly more pain reduction than the PRF group. The prevalence of pain reduction by at least 50% was lower in the PRF group than in the CRF group. The proportion of patients with &gt; 50% reduction in the NRS was 71% in the CRF versus 50% in the PRF group at the final follow-up. Conclusion: CRF was associated with earlier and longer pain reduction than PRF in patients with TON. Therefore, CRF should be recommended for patients with TON as much as possible.

A new neuromodulation method in chronic migraine; non-ınvasive pulsed radiofrequency, a single-blinded, randomised, controlled trial.

Non-invasive pulsed radiofrequency (NipRF) therapy, a neuromodulation method for peripheral nerves, is a new treatment modality for pain. We aimed to show the changes in pain severity and frequency per month in chronic migraine with NipRF treatment. We treated patients diagnosed with chronic migraine according to the International Classification of Headache Disorders III beta diagnostic criteria. In half of the patients, we applied pulsed radiofrequency (pRF) treatment with transcutaneous electrodes to the greater occipital nerve (GON) trace. In the other half, we applied the GON block under ultrasound guidance. The Migraine Disability Assessment Scale (MIDAS) was administered to the participants, and those with scores > 2 were included in the study. Pain intensity and frequency were evaluated using the visual analog scale (VAS) and a headache diary completed before and 4weeks after treatment. When both groups were compared, the pre- and post-treatment VAS scores and headache frequencies were similar. Comparing the pre-treatment and post-treatment values within the groups, VAS scores and headache frequency decreased significantly after treatment in both groups (p < 0.001). In this study, we observed that NipRF treatment is safe and effective for treating chronic migraine. Pain intensity and frequency decreased with NipRF treatment, similar to that in the GON block group. NCT05499689, Date: 08/11/2022.

Treatment of Greater Trochanteric Pain Syndrome With Ultrasound-Guided Bipolar Pulsed Radiofrequency of the Trochanteric Branches of the Femoral Nerve: A Case Series of Nine Patients.

Greater trochanteric pain syndrome (GTPS) is a prevalent cause of lateral hip pain that often leads to significant functional limitations. Conservative treatment options include physical therapy, pharmacological treatment, and more invasive techniques such as corticosteroid injections. However, despite the high success rates reported with corticosteroid injections, a significant number of patients have their symptoms persist or recur. In this case series, we present the outcomes of nine patients with GTPS who underwent ultrasound-guided bipolar pulsed radiofrequency targeting the trochanteric branches of the femoral nerve. We aim to discuss the effectiveness and safety of this approach. Eligible patients referred to our centre underwent ultrasound-guided bipolar pulsed radiofrequency aimed at the trochanteric branches of the femoral nerve. The procedure consisted of one cycle at 42°C for six minutes, followed by the injection of ropivacaine (0.2%, 3 mL) and dexamethasone (12 mg). The Brief Pain Inventory - Short Form (BPI-sf)and Lequesne Algofunctional Index (LAI) were used before the procedure and at the third and sixth months post-procedure. We monitored immediate and late complications, as well as adverse effects. Our results indicate a favourable outcome for most patients, with an average pain reduction of 76.51% according to their report of the BPI-sf. Additionally, eight out of nine patients experienced at least 50% relief. These findings align with a previous case series, which reported a similar average pain reduction. Before the procedure, most patients were classified as "extremely severe" in the LAI, with an average score of 18.17. Although there was only a slight reduction of 16.84% at the six-month follow-up, this suggests a potential improvement in their functional status. We did not observe any immediate complications or adverse effects after the procedure, nor were any reported at the subsequent follow-ups, which is consistent with existing literature. Our study suggests that ultrasound-guided bipolar pulsed radiofrequency treatment is a promising minimally invasive technique for GPTS, especially for patients who do not respond to conservative treatments. Although our case series provides some evidence of effectiveness and safety, further controlled studies on a larger scale are necessary, particularly to compare this intervention with the use of corticosteroid injections alone.

Effect of CT-Guided Repeated Pulsed Radiofrequency on Controlling Acute/Subacute Zoster-Associated Pain: A Retrospective Cohort Study.

Zoster-associated pain (ZAP) treatment and management is still inadequate. Repeated intervention protocol is often applied to manage ZAP. This study aimed to retrospectively investigate the effect of repeated applications of pulsed radiofrequency therapy on controlling acute/subacute ZAP. From March 2019 to December 2021, 150 patients with acute/subacute ZAP who underwent repeated application of pulsed radiofrequency treatment (R-PRF) and pulsed radiofrequency combined paravertebral block interventions (PRF + PVB) in the Pain Department of the affiliated Hospital of Jiaxing University were enrolled. Patients were grouped by intervention protocol and received at least 12months of follow-up assessments using the Numerical Rating Scale score (NRSs), Pittsburg Sleep Quality Index (PSQI), Simple McGill Pain Questionnaire-2 score (SF-MPQ-2s), and follow-up interventions. Both groups experienced a reduction in the incidence of clinically meaningful ZAP after the intervention therapy. In the R-PRF group, there were 36 cases of clinically meaningful ZAP within the first month post-treatment, while the PRF + PVB group had 38 cases. The incidence of clinically meaningful ZAP, as determined by multivariable generalized estimating equations, was 42.86% in the R-PRF group and 57.58% in the PRF + PVB group during the first month of follow-up. There was a significant difference in the incidence of clinically meaningful ZAP between the two groups after 1month of treatment (adjusted odds ratio: 0.40; 95% confidence interval: 0.18-0.91; p = 0.03). Both R-PRF and PRF + PVB treatments effectively relieve pain in patients with acute/subacute ZAP. However, R-PRF may have superior efficacy compared to PRF + PVB in reducing the incidence of clinically meaningful ZAP 1month after treatment.

Dual-neuromodulation strategy in pain management of herpes zoster ophthalmicus: retrospective cohort study and literature review

Background Effective pain control of herpes zoster ophthalmicus (HZO) is not only essential to attenuate the clinical symptoms but to reduce the risk of postherpetic neuralgia development. Recently, neuromodulation therapy has been one promising option for neuropathic pain and increasingly applied in management of zoster-related pain. One key factor of neuromodulation treatment is the therapeutic site for the impaired nerves. In this study we aim to investigate one novel dual-neuromodulation strategy, targeting the level of the peripheral branch and trigeminal ganglion, in the pain management of HZO. Methods Dual neuromodulation strategy combining short-term peripheral nerve stimulation (PNS) with pulsed radiofrequency (PRF) of trigeminal ganglion was compared with single PNS treatment for HZO-related pain. Clinical recordings of patients were retrospectively reviewed. The primary outcome was the pain severity, assessed by the visual analogue scale (VAS) before and after neuromodulation therapy. Results PNS achieved significant relief of pain with or without PRF treatment before discharge, which provided enduring therapeutic effect up to 12-month follow-up. The mean reduction of VAS was 6.7 ± 1.4 in dual modulation therapy (n = 13) at last follow-up and 5.4 ± 1.5 in PNS subgroup (n = 20), respectively. Moreover, dual modulation strategy provided better control of pain compared with PNS therapy alone at each time point. Conclusion It is feasible and effective to combine the PNS and PRF in pain management of HZO. This novel dual modulation strategy of trigeminal pathway may provide additional therapeutic effects of pain symptoms in HZO population.

Pulsed Radiofrequency Ablation of the Lumbar and Sacral Plexus for Intractable Pain in Pediatric Patients

Severe and persistent pain of cancer and noncancer origin in pediatric patients can pose significant challenge to manage. The application of Radiofrequency ablation in Pediatric patients for pain management is not well reported in the literature. Here, we present pediatric cases where pulsed radiofrequency (PRF) treatment of the Lumbosacral plexus was done for pain relief.

1. Lumbosacral radicular pain.

Patients suffering lumbosacral radicular pain report radiating pain in one or more lumbar or sacral dermatomes. In the general population, low back pain with leg pain extending below the knee has an annual prevalence that varies from 9.9% to 25%. The literature on the diagnosis and treatment of lumbosacral radicular pain was reviewed and summarized. Although a patient's history, the pain distribution pattern, and clinical examination may yield a presumptive diagnosis of lumbosacral radicular pain, additional clinical tests may be required. Medical imaging studies can demonstrate or exclude specific underlying pathologies and identify nerve root irritation, while selective diagnostic nerve root blocks can be used to confirm the affected level(s). In subacute lumbosacral radicular pain, transforaminal corticosteroid administration provides short-term pain relief and improves mobility. In chronic lumbosacral radicular pain, pulsed radiofrequency (PRF) treatment adjacent to the spinal ganglion (DRG) can provide pain relief for a longer period in well-selected patients. In cases of refractory pain, epidural adhesiolysis and spinal cord stimulation can be considered in experienced centers. The diagnosis of lumbosacral radicular pain is based on a combination of history, clinical examination, and additional investigations. Epidural steroids can be considered for subacute lumbosacral radicular pain. In chronic lumbosacral radicular pain, PRF adjacent to the DRG is recommended. SCS and epidural adhesiolysis can be considered for cases of refractory pain in specialized centers.

Comparison of Peripheral Nerve Conventional and Pulse Radiofrequency Applications in Patients with Primary Trigeminal Neuralgia: A Retrospective Analysis

Aim: This study aims to retrospectively investigate the results of continuous radiofrequency (CRF) and pulsed radiofrequency (PRF) applications to the peripheral branches of the trigeminal nerve in patients with trigeminal neuralgia (TN).&#x0D; Material and Methods: Patients who experienced a significant reduction in pain symptoms after local anesthetic application to the peripheral branches of the trigeminal nerve were divided into two groups. The first group received PRF treatment and the second group received CRF treatment. Pain intensity scores of both groups at 1 and 3 months were compared. The results were analyzed retrospectively.&#x0D; Results: Among the participants, 10 received PRF treatment and another 10 received CRF treatment. At the 1st month follow-up, both groups demonstrated considerable reductions in pain levels. By the 3rd month, no substantial disparities were noted between the two groups in terms of pain-related disability and pain intensity.&#x0D; Conclusion: Both PRF and CRF interventions emerge as effective and secure techniques applicable to the peripheral branches of the trigeminal nerve. They should be contemplated as valuable options in cases where conventional medical treatments fall short in delivering adequate pain control.

The clinical observation of DRG pulsed radiofrequency treatment for chronic musculoskeletal disease

Objective: To observe the clinical effect of Chronic Musculoskeletal Pain (CMP). Methods: 80 CMP patients admitted to our department from January 2022 to June 2023 were selected as the pain improvement after pulse radiofrequency treatment. Results: The total response rate at 1 week and 4 weeks was 91.25% and 97.50%, respectively. The excellent rate at 4 weeks after treatment was significantly higher than at 1 week after treatment. VAS scores were significantly lower at 1 week and 4 weeks after treatment than before treatment (P&lt;0.05). Conclusion: Pulsed radiofrequency therapy for CMP has a significant clinical effect, significant pain improvement, and significantly improved quality of life. It is a widely used interventional therapy in chronic pain.

Pulsed radiofrequency or surgery for anterior cutaneous nerve entrapment syndrome: Long-term results of a randomized controlled trial.

Patients with anterior cutaneous nerve entrapment syndrome (ACNES) often require a step-up treatment strategy including abdominal wall injections, pulsed radiofrequency (PRF) or a neurectomy. Long-term success rates of PRF and surgery are largely unknown. The aim of the current study was to report on the long-term efficacy of PRF and neurectomy in ACNES patients who earlier participated in the randomized controlled PULSE trial. Patients who completed the PULSE trial were contacted about pain status and additional treatments in the following years. Treatment success was based on numerical rating scale (NRS) following IMMPACT recommendations and Patient Global Impression of Change (PGIC) scores. A total of 44 of the original 60 patients were eligible for analysis (73.3%). Median follow-up was 71.5 months. One patient (4.3%) was still free of pain after a single PRF session, and five additional patients (21.7%) were free of pain by repetitive PRF treatments. By contrast, 13 patients (61.9%) in the neurectomy group were still free of pain without additional treatments. All pain recurrences and therefore primary re-interventions occurred in the first 2 years after the initial treatment. Approximately one in five ACNES patients undergoing PRF treatment reports long-term success obviating the need of surgical intervention. Surgery for ACNES is long-term effective in approximately two of three operated patients. Recurrent ACNES beyond 2 years after either intervention is rare.

The role of radiocontrast agents in the pulsed radiofrequency treatment of lumbar dorsal root ganglion

Objective: The aim of this study was to investigate the effect of contrast agent use on procedure time and accuracy in pulsed&#x0D; radiofrequency treatment of the lumbar dorsal root ganglion.&#x0D; Patients and Methods: Patients aged 23–79 years with lumbar radicular pain due to disc herniation for at least 3 months were randomized&#x0D; into two groups of 35 patients each. Patients in both groups underwent fluoroscopy-guided pulsed radiofrequency treatment of the&#x0D; dorsal root ganglion at the level of the L5 foramen. In the radiocontrast group, unlike the control group, the location of the ganglion&#x0D; was determined by administering the contrast agent before the radiofrequency treatment.&#x0D; Results: Procedure time in the radiocontrast group was significantly longer than in the control group (P&lt; 0.05). In 50 cases ganglion&#x0D; was detected in the extraforaminal or intraforaminal location, the excitation of the ganglion in the range of 0.4–0.6 V was significantly&#x0D; higher in the radiocontrast group (95.8%) than in the control group (69.2%) (P&lt; 0.05).&#x0D; Conclusion: The use of radiocontrast material in pulsed radiofrequency application on the dorsal root ganglion prolongs the procedure&#x0D; time. However, for ganglia that cannot be detected by stimulation, contrast injection is useful on procedural accuracy

Comparison of the Effectiveness of Pulse Radiofrequency in the Treatment of Suprascapular Nerve in Chronic Shoulder Pain

Objectives: To investigate the effects of various durations of pulsed radiofrequency (PRF) application on pain and functional limitation in the short term in patients suffered from chronic shoulder pain Methods: 83 patients, 50 women (60.2%) and 33 men (39.8%) were included in the study. Treatment of PRF was implemented to the suprascapular nerve for 8 min in 44 (53.1%) and 10 min in 39 (46.9%) patients. The pain intensity of the patients was evaluated using the visual analog scale (VAS). The Shoulder Pain and Disability Index (SPADI) was utilized to define shoulder function and pain. VAS and SPADI measurements before and four weeks after treatment were recorded. Results: The VAS and SPADI scores showed a significant improvement in both treatment groups (P &lt; 0.05); however, no significant difference was observed between the groups. Conclusion: Therefore, PRF is a beneficial treatment method in patients suffered from chronic shoulder pain; furthermore, the duration of PRF treatment of 8 or 10 minutes does not affect the effectiveness of the treatment.