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Pulsed radiofrequency with nerve block improves clinical response and pain in cervical radiculopathyPulsed radiofrequency combined with nerve blocks improves neck pain

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Key Takeaway
Consider pulsed radiofrequency with nerve block for improved clinical response and pain in cervical radiculopathy.

This meta-analysis evaluated the efficacy of pulsed radiofrequency combined with nerve block compared to nerve block alone for adults with cervical radiculopathy or cervical nerve root pain. The analysis included 783 patients and reported a significantly improved overall clinical response rate (RR 1.13; 95% CI: 1.05 to 1.22) for the combination therapy. Additionally, patients receiving the combination therapy showed a reduction in pain intensity (MD -0.87; 95% CI: -1.27 to -0.47) and an increase in cervical flexion-extension range of motion (MD 8.56; 95% CI: 1.67 to 15.44).

The authors noted that while the combination therapy showed promise, the pooled pain difference was modest. Furthermore, evidence for functional improvements was supported by only a few studies, leaving the certainty of these outcomes limited. No significant difference in adverse events was reported between the two groups.

Clinically, pulsed radiofrequency combined with nerve block may provide greater pain relief and better overall clinical response than nerve block alone without increasing short-term adverse reactions. However, the evidence does not establish durable benefit beyond the reported follow-up periods, and the limited number of studies supporting functional outcomes necessitates a cautious interpretation of long-term benefits.

Living with neck nerve pain, known as cervical radiculopathy, can make simple movements like turning your head difficult. A review of data from 783 adults looked at whether adding a specific treatment called pulsed radiofrequency to a standard nerve block helps manage these symptoms.

The results showed that patients who received both treatments had a better overall clinical response compared to those who only received the nerve block. This combination also led to lower pain scores and a better range of motion when moving the neck. While the improvement in pain was modest, the combined treatment did not cause more side effects than the nerve block alone.

It is important to note that some parts of the evidence are still limited. Only a few studies provided data on how much movement improved, and we do not know if these benefits last for a long time. Because the evidence for long-term results is not yet clear, talk to your doctor about how these findings apply to your specific situation.

What this means for you:
Combining pulsed radiofrequency with nerve blocks may improve pain and neck movement for those with nerve issues.

Common questions

Does adding pulsed radiofrequency make the treatment less safe?

No, the study found no significant difference in adverse events when comparing the combined treatment to a nerve block alone. This means the combination was as well tolerated as the standard procedure for patients with neck nerve pain.

How much does it help with neck movement?

Patients who received both treatments showed an increase in their range of motion for neck flexion and extension. However, researchers noted that the evidence for these functional improvements comes from only a few studies.

How much pain relief does the combination provide?

The combination of pulsed radiofrequency and a nerve block resulted in a reduction in pain intensity. While the improvement was noted as modest, it was statistically significant compared to receiving a nerve block alone.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedSep 2026
View Original Abstract ↓
BackgroundCervical radiculopathy is a common cause of neck–shoulder–arm pain and functional impairment. Although nerve block provides rapid analgesia, its durability may be limited. This systematic review and meta-analysis evaluated whether pulsed radiofrequency combined with nerve block offers superior efficacy and comparable safety to nerve block alone.MethodsEight databases were searched from inception to April 10, 2026. Randomized controlled trials comparing pulsed radiofrequency plus nerve block with nerve block alone in adults with cervical radiculopathy or cervical nerve root pain were included. Meta-analysis was performed using RevMan 5.4. Risk ratios or mean differences with 95% confidence intervals were calculated.ResultsNine randomized controlled trials involving 783 patients were included. Compared with nerve block alone, combined therapy significantly improved the overall clinical response rate (RR = 1.13, 95% CI: 1.05–1.22), reduced pain intensity measured by VAS score (MD = −0.87, 95% CI: −1.27 to −0.47), increased cervical flexion–extension range of motion (MD = 8.56, 95% CI: 1.67–15.44), and improved Yasuhisa Tanaka symptom scores (MD = 2.61, 95% CI: 1.81–3.40). No significant difference was observed in adverse reactions (RR = 0.96, 95% CI: 0.52–1.78).DiscussionPulsed radiofrequency combined with nerve block may provide greater pain relief and better overall clinical response than nerve block alone without increasing short-term adverse reactions. Nevertheless, the evidence for functional improvement remains uncertain. The pooled pain difference was modest, functional outcomes were supported by few studies, and the available evidence does not establish durable benefit beyond the reported follow-up periods. Further high-quality multicenter trials are needed to confirm long-term efficacy, clarify functional benefits, and optimize treatment protocols.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251271276, Identifier: CRD420251271276.
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