"What if a simple zap to the spine could relieve the debilitating lower back and leg pain brought on by a herniated disk Such is the promise of pulse radiofrequency therapy pRF which sends inflammationreducing pulses of energy to nerve roots in the spine a new study claims. The therapy is not new having first received U.S. Food and Drug Administration approval in the s. But recent advances in CT scan technology now enable clinicians to deploy those energy pulses with much more accuracy experts said. And the new research suggests the treatment could prove a boon to back pain patients for whom standard therapies have failed to do the trick. I was amazed with the results of pRF said study author Dr. Alessandro Napoli. Especially having read as a radiologist numerous lumbar MRI scans of patients with recurrent hernia after surgery. And as a patient himself Napoli added that from personal experience I can tell you that the treatment is not painful and the results are appreciated within days after a single treatment lasting  minutes. Napoli is a professor of interventional radiology at Sapienza University of Rome in Italy. He and his colleagues plan to report their findings Tuesday at the Radiological Society of North America annual meeting in Chicago. Such research is considered preliminary until published in a peerreviewed journal. Lower disk herniation results when the insulating disks that sit between spinal vertebrae tear open allowing jellylike material to protrude and exert pressure on surrounding nerve roots. Beyond lower back pain the condition often triggers sciatica a pain that radiates down a patients leg. Standard therapies include overthecounter pain meds corticosteroid spinal injections andor invasive spine surgery that sometimes involves disk removal and vertebrae fusion. The problem said Napoli is that such options entail risks without assured relief. Steroid injections are effective only in portion of the patients and generally require more sessions he noted. And though surgery safety has largely improved Napoli pointed to the risk for bleeding and infection the need for a minimum two to threeday hospital stay the high cost and the fact that some patients ultimately realize little benefit. By contrast pRF is scalpelfree delivering radio signals directly to affected nerves via a CT scanguided electrode. The process said Napoli requires no hospital stay is noninvasive far cheaper and less risky. The rationale for using pRF on disk herniation is that we eliminate the inflammation process of the compromised nerve root he explained. Without inflammation the pain fades and the body starts a selfhealing process that allows for complete resolution of the disk herniation in a large proportion of patients. For the study the Italian investigators compared  lumbar herniation patients who underwent a single minute round of CTguided pRF with  patients who received one to three rounds of steroid injections. All the patients had already undergone standard interventions with poor results. By the oneyear mark following either treatment a full perceived recovery was reported by  percent of the pRF patients compared with just  percent of the steroid injection patients. Dr. Daniel Park director of minimally invasive orthopedic spine surgery at William Beaumont Hospital in Royal Oak Mich. offered some caution on the findings. He noted that because the majority of people with back pain improve with time and exercise alone it remains an open question as to whether the pRF procedure really cured the condition. Still Park noted that diagnostic uncertainty can undermine the ability of surgery to get at the true source of a patients pain given that the problem with low back pain is that there are many causes of it and physicians have trouble identifying the cause of pain. Nevertheless he remains unsure if pRF is truly ready for prime time. Best case I think pRF could be an option for people if they have already failed therapy and medication said Park. It may be a similar option for people if they do not or cannot have steroid injections but they need more treatment. I think this is experimental and should not be firstline. More information The American Academy of Orthopaedic Surgeons offers more information on herniated disks httpsorthoinfo.aaos.orgendiseasesconditionsherniateddiskinthelowerback. SOURCES Alessandro Napoli M.D. Ph.D. interventional radiologist and professor interventional radiology department of radiological oncological and pathological science Sapienza University of Rome Italy Daniel Park M.D. orthopedic spine surgeon associate professor orthopedic spine surgery and director Minimally Invasive Orthopedic Spine Surgery William Beaumont Hospital Royal Oak Mich. Nov.   Radiological Society of North America annual meeting Chicago"