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Refractory chronic ankle pain controlled with pulsed radiofrequency: case report

BACKGROUND AND OBJECTIVES: Radiofrequency (RF) is an alternate current with oscillation frequency of 500,000 Hz, which has been successfully used to treat some morbidities evolving with chronic pain. This case report aimed at showing the successful use of sural nerve pulsed RF to treat chronic ankle pain. CASE REPORT: Female patient, 60 years old, with right ankle pain for five years, refractory to treatment with opioids, non-steroid anti-inflammatory drugs (NSAIDs), dipirone, antidepressants and anticonvulsants, physical therapy, localized infiltrations, acupuncture and insole. Patient was submitted to right sural nerve pulsed RF. Needle was inserted in the line between the Achilles tendon and lateral malleolus, initial Achilles tendon region and final soleus and gastrocnemius muscles region. Sensory stimulation to identify the sural nerve was with 0.5 volts and 50 Hz. Pulsed current was applied for 140 seconds with 45 volts and temperature of up to 42º C. Patient was submitted to two sessions with improvement of approximately 80% of pain, allowing her to walk or to remain standing up without major difficulties. CONCLUSION: Sural nerve pulsed RF may be an option to control chronic ankle pain.

Ankle; Chronic pain; Treatment with pulsed radiofrequency


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