Authors' recommendations: The use of RFA for all back pain has dramatically increased in Alberta between 2005 and 2011 indicating the popularity of the procedure in mitigating chronic back pain. The volume of patients seeking RFA treatment for CLBP has contributed to long waitlists, but not all patients with CLBP are good candidates for the procedure. Key informants have suggested that Alberta needs a more comprehensive structure for managing patients with CLBP. Appropriate assessment and referral for RFA are considered as an important part of any changes to the current system. RFA is considered a medical procedure and does not require Health Canada regulatory approval. The reports available on safety and adverse events are limited. However, the two available studies report minor complications indicating that RFA is a relatively safe procedure with very few side effects. We identified 6 RCTs reporting on the efficacy of RFA in LFJs. There is a statistically significant improvement of 0.60 on the 0-10 VAS scale associated with RFA compared to control. However, the clinically meaningful difference is 2 points on the VAS scale. Thus, based on the available RCT evidence RFA is not an effective treatment to decrease pain associated with LFJs. In the SIJ, DLBP and coccydynia, observational data was the primary source of effectiveness. Improvements in pain were reported in all three types of pain (3.23-point increase for SIJ, 2.95-point increase for DLBP and 52-point increase for coccydynia). However, in the absence of a control group, it is unknown if RFA is more beneficial than other treatment options. The pain improvements associated with RFA is unclear in these clinical subgroups. In addition, all of the studies are of moderate to low quality. RCTs are required in these clinical subgroups. The findings of this HTA are similar to other systematic reviews and HTAs on RFA for CLBP.

Project Status: Completed

Year Published: 2012

URL for published report: https://wcm.ucalgary.ca/iph/system/files/rfa-for-low-back-pain.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: HTA Unit, University of Calgary

Contact Address: 3rd Floor, TRW Building, University of Calgary, 3280 Hospital Dr NW, Calgary, Alberta, Canada, T2N 4Z6

Contact Name: fclement@ucalgary.ca

Contact Email: fclement@ucalgary.ca

Copyright: University of Calgary