Radiofrequency ablation in chronic pain syndromes: An evidence- and consensus-based indian society for the study of pain guidelines, 2022

Abstract

Chronic pain is a frequent, intricate, and adverse condition that has a considerable influence on individuals and society at large. In India, its prevalence is around 20%. Although a spectrum of conservative treatment modalities is available, a significant proportion of patients with chronic pain syndromes remain refractory and require surgical intervention. In these groups of patients, radiofrequency ablation (RFA) techniques are safe minimally invasive treatments and provide significant and durable pain relief. Thus, we aimed to formulate the Indian Society for the Study of Pain (ISSP) guidelines for the management of chronic pain syndromes with various RFA techniques. An in-depth literature review by experts in Pain Medicine practising in India, was used to produce 16 statements across 4 common chronic pain syndromes, including knee pain, headache and facial pain, lumbar facet joint pain, and sacroiliac joint pain. The quality of evidence was assessed with the Third US Preventive Service Task Force guidance document and the strength of the recommendation was determined by the Delphi consensus process. The level of evidence for most of the statements was I. Moreover, for most statements, the level of agreement between the experts was good (≥80% of the experts). The ISSP guidelines for the management of chronic pain syndromes are developed by experts in pain medicine. For most of the statements, the highest level of evidence was available and inter-expert agreement was good. However, further high-quality research is required to formulate more inclusive guidelines in this evolving pain medicine speciality.