Successful Pain Treatment with Pulsed Radio Frequency Energy Therapy in Venous Ulcers

At the WOCN Conference in 2010, we reported success using Pulsed Radio Frequency Energy (PRFE) to accelerate healing of venous ulcers.  We believe that part of the wound healing success in these wounds may be attributed to a decrease in pain with PRFE which enables the patient to better tolerate compression bandages.  Pain is a well-acknowledged complication of venous ulcers. (1-4)   Two case studies involving pain reduction and healing are presented.

 The mechanism by which PRFE alleviates pain is largely unknown, however, it has been demonstrated to increase the expression of cytokines and augment the production of anti-inflammatory agents. (3,5)  

Patient 1: A 78 year old male with diabetic neuropathy, PAD and a prior amputation on the right leg, presented with a 3-month history of persistent painful venous ulcers on his left leg (9/10 on VAS). Prior clinicians had recommended a second amputation due to inability to surgically correct the vascular etiology.   PRFE therapy was prescribed for pain and compression applied.  PRFE is administered  by the patient in the home. The patient’s pain decreased to 1/10 within 7 weeks of treatment. Within 14 weeks, the wounds were completely healed.

 Patient 2: A 57 year old male with lupus and mixed arterial and venous disease presented in severe pain (10/10 on VAS) with a 6-year history of bilateral venous ulcers. The patient had previously refused compression due to pain, and required Fentanyl patches and Oxycodone.  No medication provided relief for more than 3 hours.  PRFE therapy was initiated for pain and compression was applied.  The patient’s pain resolved completely and pain medication requirements decreased dramatically within weeks.

 These 2 cases demonstrate a nonpharmaceutical approach to pain reduction enabling the patient to tolerate compression.  Compression therapy combined with PRFE may have promoted healing in these two cases. This approach warrants further study.