Nerve Block Technique Might Help Ease Chronic Back Pain
Small study found half of patients still getting pain relief a year out from treatment
By Dennis Thompson
TUESDAY, Feb. 23, 2016 (HealthDay News) -- A procedure that uses radio waves to treat chronic low back pain provided long-lasting relief to a small group of patients, researchers report.
Called intradiscal biacuplasty (IDB), the procedure uses two water-cooled needles to blast radiofrequency energy at the nerve fibers within and around a spinal disc that's begun to degenerate but has not ruptured, explained lead researcher Dr. Michael Gofeld.
"Basically you're destroying the nerve fibers, which will lead to the elimination of pain," he said. Gofeld is a chronic pain management specialist at St. Michael's Hospital and Women's College Hospital in Toronto.
A year out from treatment, half of the patients who received IDB in the study said they still were experiencing significant pain reduction, Gofeld and his colleagues reported.
The treatment is specifically to help people with discogenic back pain, Gofeld said -- pain related to discs that are deteriorating but have not ruptured.
Prior studies have found that discogenic back pain accounts for 39 percent of cases of chronic lower back pain, he said.
The idea of using radio waves to treat back pain has been around for a quarter-century, Gofeld said. But recent breakthroughs using water-cooled needles have made the technology potentially more effective.
"If the needle gets too hot, the energy will not spread efficiently enough," Gofeld said.
The procedure takes about a half hour, followed by six weeks of physical therapy, he said. Ideal patients have lower back pain that doesn't shoot down the legs and limited disc degeneration, with no significant tears or ruptures.
Dr. John Mafi, an internist and assistant professor at UCLA's David Geffen School of Medicine, in Los Angeles, pointed out that the U.S. Food and Drug Administration approved IDB for use in 2007. But the technology has not been widely adopted in the United States, he said.
"It's not widely used," Mafi said. "Insurance doesn't seem to cover it yet, and that may be because they want to see more evidence."
For example, the U.S. Centers for Medicare and Medicaid Services (CMS) ruled in September 2008 that the government insurance plans would not cover any radiofrequency treatments for low back pain. The CMS decision memo concluded that there wasn't enough evidence to prove that the procedures would improve health outcomes.