Novel technique 'stuns' arthritis pain in shoulder and hip

Date:
November 16, 2020
Source:
Radiological Society of North America
Summary:
A novel outpatient procedure offers lasting pain relief for
patients suffering from moderate to severe arthritis in their hip
and shoulder joints.



FULL STORY ==========================================================================
A novel outpatient procedure offers lasting pain relief for patients
suffering from moderate to severe arthritis in their hip and shoulder
joints, according to a study presented at the annual meeting of the Radiological Society of North America (RSNA). Researchers said the
procedure could help reduce reliance on addictive opiates.


========================================================================== People with moderate to severe pain related to osteoarthritis face limited treatment options. Common approaches like injections of anesthetic and corticosteroids into the affected joints grow less effective as the
arthritis progresses and worsens.

"Usually, over time patients become less responsive to these injections,"
said Felix M. Gonzalez, M.D., from the Radiology Department at
Emory University School of Medicine in Atlanta, Georgia. "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."
Without pain relief, patients face the possibility of joint replacement surgery. Many patients are ineligible for surgery because of health
reasons, whereas many others choose not to go through such a major
operation. For those patients, the only other viable option may be opiate painkillers, which carry the risk of addiction.

Dr. Gonzalez and colleagues have been studying the application of a novel interventional radiology treatment known as cooled radiofrequency ablation
(c- RFA) to achieve pain relief in the setting of advanced degenerative arthritis.

The procedure involves the placement of needles where the main sensory
nerves exist around the shoulder and hip joints. The nerves are then
treated with a low-grade current known as radiofrequency that "stuns"
them, slowing the transmission of pain to the brain.

For the new study, 23 people with osteoarthritis underwent treatment,
including 12 with shoulder pain and 11 with hip pain that had become unresponsive to anti-inflammatory pain control and intra-articular lidocaine-steroid injections. Treatment was performed two to three weeks
after the patients received diagnostic anesthetic nerve blocks. The
patients then completed surveys to measure their function, range of
motion and degree of pain before and at three months after the ablation procedures.



========================================================================== There were no procedure-related complications, and both the hip and
shoulder pain groups reported statistically significant decrease in the
degree of pain with corresponding increase in dynamic function after
the treatment.

"In our study, the results were very impressive and promising,"
Dr. Gonzalez said. "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 procedure offers a new alternative
for patients who are facing the prospect of surgery. In addition, it
can decrease the risk of opiate addiction.

"This procedure is a last resort for patients who are unable to be
physically active and may develop a narcotic addiction," Dr. Gonzalez
said. "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." At last
year's RSNA annual meeting, Dr. Gonzalez presented similarly encouraging results from a study of a similar procedure for the treatment of knee arthritis. Together, the knee, shoulder and hip articulations account
for approximately 95% of all arthritis cases.

The procedure could have numerous applications outside of treating
arthritic pain, Dr. Gonzalez explained. Potential uses include treating
pain related to diseases like cancer and sickle cell anemia-related pain syndrome, for example.

"We're just scratching the surface here," Dr. Gonzalez said. "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." Co-authors are Omar N. Kallas, M.D., Nima Kokabi,
M.D., Zachary Bercu, M.D., David Reiter, Monica B. Umpierrez, M.D., Yi
N. Guo, Adam D. Singer, M.D., Janice M. Newsome, M.D., Shervin Oskouei, Nickolas Reimer, and Philip K. Wong, M.D.


========================================================================== Story Source: Materials provided by
Radiological_Society_of_North_America. Note: Content may be edited for
style and length.


==========================================================================


Link to news story: https://www.sciencedaily.com/releases/2020/11/201116075724.htm

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