Interventional radiofrequency in chronic pain management: Mechanisms, clinical applications and current evidence

Chronic pain represents a major public health challenge, affecting nearly 20% of the world's population and substantially impairing quality of life, physical function and psychosocial well-being. Although pharmacological therapies remain the cornerstone of treatment, their effectiveness may be limited and long-term use is often associated with significant adverse effects. Consequently, interventional pain management has emerged as an essential component of multidisciplinary chronic pain care.
Interventional radiofrequency (RF) is a minimally invasive technique that uses high-frequency electrical current to modulate or interrupt nociceptive transmission within targeted neural structures. Performed under imaging guidance, RF enables precise treatment delivery with a low complication rate.
Several radiofrequency modalities are currently available, including conventional thermal radiofrequency, pulsed radiofrequency, and cooled radiofrequency. These techniques differ in their biological mechanisms, thermal characteristics, and therapeutic objectives. RF has been applied successfully in a wide range of chronic pain conditions, including facet joint syndrome, chronic lumboradicular pain, sacroiliac joint dysfunction, peripheral neuropathic pain and osteoarthritis-related joint pain, particularly of the knee.
This narrative review aims to summarize the mechanisms of action, technical principles, clinical applications, and current evidence supporting the use of radiofrequency in chronic pain management.
Accumulating evidence supports that RF provides sustained pain relief and functional improvement in appropriately selected patients, making it an important therapeutic option within contemporary pain medicine.