Efficacy of Radiofrequency Ablation or Spinal Cord Stimulation for Management of Chronic Mechanical Low Back Pain

With over 191 million prescriptions for opioid medications being written annually, 11.5 million Americans abusing opioid prescription medications each year and on average 130 Americans dying from opioid overdoses every day1, finding alternatives to opioids for the management of chronic pain is more important now than ever. Since the early 1999s opioids have been the primary method for managing chronic pain. While the number of opioid prescriptions has decreased since its peak in 2010, the morphine milligram equivalents of the prescriptions written today are generally three times greater than they were in 1999. Non-pharmacological methods for chronic pain management such as radiofrequency ablation, spinal cord stimulation, acupuncture, massage, chiropractic, and meditation are available and are being offered to patients more often now than during peak opioid prescription writing. Many patients may be hesitant to try these different methods for pain management for a number of reasons: radiofrequency ablation and spinal cord stimulation are more invasive than pain medications, research confirming their efficacy compared with opioid medications is limited, and many patients whose pain is controlled on opioids fear that changing therapy might increase their pain. Of the non-medicinal therapies, radiofrequency ablation and spinal cord stimulation will be examined as pain relief tools for patients with chronic mechanical low back pain. If they are found to be effective, then they could be confidently recommended to these patients, either as a replacement or an adjunctive analgesic therapy, thus diminishing the reliance on opioids