Digging Deeper

Radiofrequency Denervation for Chronic Low Back Pain: What Does the Latest Evidence Tell Us?

https://bmjopen.bmj.com/content/16/7/e105106.abstract

Chronic low back pain can be incredibly frustrating for both patients and clinicians, particularly when pain persists despite best efforts with exercise, education and self-management strategies.

A new systematic review and meta-analysis examined 55 randomised controlled trials involving 4,394 participants to evaluate the effectiveness of radiofrequency (RF) denervation for facet joint pain, sacroiliac joint pain, discogenic pain and non-specific chronic low back pain.

Key Findings
✅ RF denervation produced small improvements in pain and function compared with sham treatment, steroid injections and standard care.
✅ Benefits were observed across several categories of chronic low back pain, including facet joint and sacroiliac joint pain.

⚠️ However, the improvements did not reach the predefined threshold for clinical importance. In other words, while changes could be detected statistically, patients may not experience a meaningful difference in everyday life.
⚠️ The certainty of the evidence ranged from very low to moderate, and many studies had methodological limitations.

What Does This Mean?
The findings suggest that RF denervation may provide some benefit for selected patients, but it is unlikely to be the “game changer” that many people living with chronic low back pain hope for.
This highlights an important principle in modern pain management:
Pain outcomes are often improved more by building function, flexibility and confidence than by focusing solely on changing tissues or interrupting pain signals.

At ACTforPAIN, we take a biopsychosocial approach to persistent pain. Evidence increasingly shows that helping people improve:
Psychological flexibility
Activity participation
Sleep quality
Self-management skills
Values-based living
can lead to meaningful improvements in quality of life, even when pain remains present.

The Bigger Picture
Interventional procedures may have a role for some individuals, but chronic pain is complex. The best outcomes often come from combining appropriate medical care with evidence-based behavioural and psychological approaches that help people live well alongside pain.

ACTforPAIN is an evidence-based programme that helps people develop practical skills for managing chronic pain and building a meaningful life beyond pain.
🌐 www.ACTforPAIN.com
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