• Am J Sports Med · May 2007

    Pain relief through an antinociceptive effect after radiofrequency application.

    • Norimasa Takahashi, James P Tasto, Mark Ritter, Nobuyasu Ochiai, Seiji Ohtori, Hideshige Moriya, and David Amiel.
    • Department of Orthopedic Surgery, University of California, San Diego, La Jolla, California 92093-0630, USA.
    • Am J Sports Med. 2007 May 1; 35 (5): 805-10.

    BackgroundMany patients with chronic tendinosis have experienced early pain relief after application of bipolar radiofrequency treatment. Pathologic nerve ingrowth or nerve irritation in the tendon has been considered as a possible cause of the pain experienced with tendinosis.HypothesisBipolar radiofrequency treatment will ablate nerve fibers, resulting in pain relief.Study DesignControlled laboratory study.MethodsEighteen Sprague-Dawley rats were used in this study. Eight rats were treated with 2 points of bipolar radiofrequency applications applied to the hind paws with the Topaz microdebrider device, 6 sham rats had a needle applied to the hind paws, and there were 4 control rats. Tissues were processed for neural class III beta-tubulin (TUJ-1) or calcitonin gene-related peptide (CGRP) immunohistochemistry by using the free-floating avidin-biotin complex technique. The numbers of TUJ1-immunoreactive and CGRP-immunoreactive nerve fibers in the epidermis were counted and compared with sham and control.ResultsThe number of nerve fibers demonstrated by both the antibodies of TUJ1 and CGRP were significantly decreased (P = .0002-.002) during the first 2 weeks after bipolar radiofrequency treatment. Macroscopically, the foot pad showed 2 dimples on the surface after bipolar radiofrequency treatment. Although it still showed a scar after 7 days, after 14 days it looked no different than the untreated contralateral control foot pad and foot pad of the sham group.ConclusionBipolar radiofrequency treatment induced acute degeneration and/or ablation of sensory nerve fibers.Clinical RelevanceDegeneration or ablation of nerve fibers after bipolar radiofrequency treatment may explain the early postoperative pain relief after microtenotomy for tendinosis.

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