OAK BROOK, Ill. — One of the ironies of life is that by the time people retire, their plans to enjoy golf, tennis, or other activities can evaporate due to osteoarthritis pain. Even simple joys may be curtailed because there is more pain than pleasure. Options for traditional arthritis therapy are slim and each comes with a downside. Steroid injections eventually offer shorter and shorter periods of relief. Opioids can become addictive. Joint-replacement surgery is invasive, time-consuming, and not always an option when there are underlying health conditions. Now, a team of medical researchers has found what they believe will become another option for people with moderate to severe arthritis pain in their shoulders and hips.
“Until recently, there was no other alternative for the treatment of patients at the end of the arthritis pathway who do not qualify for surgery or are unwilling to undergo a surgical procedure,” explains lead study author Felix M. Gonzalez, M.D., from the Emory University School of Medicine Radiology Department, in a media release. “The first anesthetic-corticosteroid injection may provide six months of pain relief, the second may last three months, and the third may last only a month. Gradually, the degree of pain relief becomes nonsignificant.”
Researchers have been looking into new ways to use cooled radiofrequency ablation (c-RFA), a novel interventional radiology treatment, to provide pain relief for advanced degenerative arthritis. With c-RFA, needles are placed at the location of the main sensory nerves around the shoulder or hip joint. Then a low-grade radiofrequency current is applied, “stunning” the nerves and slowing down pain transmission to the brain.
Significant decrease in arthritis pain for patients
For the new study, 23 participants with osteoarthritis received the treatment, 12 with shoulder pain and 11 with hip pain. All had reached a point in which their pain levels had become unresponsive to anti-inflammatory pain control and intra-articular lidocaine-steroid injections.
Two to three weeks after the participants received diagnostic anesthetic nerve blocks, researchers performed the c-RFA treatment. Study authors asked each patient to complete surveys before and after the ablation procedure for a comparison of function levels, range of motion, and severity of pain.
Both groups reported statistically significant reductions in pain along with comparable increases in dynamic function after receiving the treatment. The study results found no treatment-related complications.
“In our study, the results were very impressive and promising,” Gonzalez says. “The patients with shoulder pain had a decrease in pain of 85%, and an increase in function of approximately 74%. In patients with hip pain, there was a 70% reduction in pain, and a gain in function of approximately 66%.”
The current study expands on a previous report researchers presented last year on a similar procedure to treat arthritis in the knee. Gonzalez reports that 95 percent of all arthritis cases involve the knee, shoulder, and hip joints.
Useful for patients battling cancer, other diseases?
Aside from the implications for treating arthritis, researchers see other potential uses for the procedure, including pain treatments for cancer and sickle cell anemia-related pain syndrome.
“We’re just scratching the surface here,” Gonzalez adds. “We would like to explore efficacy of the treatment on patients in other settings like trauma, amputations and especially in cancer patients with metastatic disease.”
Study findings were presented at the annual meeting of the Radiological Society of North America (RSNA).