The Anti-Inflammatory Action of Pulsed Radiofrequency—A Hypothesis and Potential Applications

Author:

Sluijter Menno E.1,Teixeira Alexandre2,Vissers Kris3ORCID,Brasil Luis Josino4,van Duijn Bert56ORCID

Affiliation:

1. Pain Medicine Center, Swiss Paraplegic Center, Guido A. Zäch-Strasse 1, 6207 Nottwil, Switzerland

2. Clinica de Dor, R. São João de Brito 610, 4100-455 Porto, Portugal

3. Department of Anesthesiology and Palliative Care, Radboud Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands

4. Department of Anesthesiology and Pain Medicine, University of Porto Alegre, Porto Alegre 90050-170, Brazil

5. PBDL, Institute Biology, Leiden University and Fytagoras BV, Sylviusweg 72, 2333 BE Leiden, The Netherlands

6. Science Department, University College Roosevelt, P.O. Box 94, 4330 AB Middelburg, The Netherlands

Abstract

In 2013, it was reported that pulsed radiofrequency (PRF) could be applied to obtain a systemic anti-inflammatory effect. Patients with chronic pain and patients with an inflammatory condition from other disciplines could potentially profit from this finding. At that time, intravenous application was used, but since then, it became clear that it could be applied transcutaneously as well. This procedure was named RedoxPRF. This can be used both for regional and for systemic application. Recently, the basic element of the mode of action has been clarified from the analysis of the effects of PRF on a standard model of muscle injury in rats. The objective of this paper is to present a hypothesis on the mode of action of RedoxPRF now that the basic mechanism has become known. Cell stress causes an increased production of free radicals, disturbing the redox equilibrium, causing oxidative stress (OS) either directly or secondarily by other types of stress. Eventually, OS causes inflammation and an increased sympathetic (nervous) system activity. In the acute form, this leads to immune paralysis; in the chronic form, to immune tolerance and chronic inflammation. It is hypothesized that RedoxPRF causes a reduction of free radicals by a recombination of radical pairs. For systemic application, the target cells are the intravascular immune cells that pass through an activated area as on an assembly line. Hypothesis conclusions: 1. RedoxPRF treatment works selectively on OS. It has the unique position of having a point of engagement at the most upstream level of the train of events. 2. RedoxPRF has the potential of being a useful tool in the treatment of inflammatory diseases and possibly of stage 4 cancer. 3. In the treatment of chronic pain, RedoxPRF is an entirely new method because it is different from ablation as well as from stimulation. We propose the term “functional restoration”. 4. Controlled studies must be conducted to develop this promising new field in medicine further.

Publisher

MDPI AG

Subject

General Medicine

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