82 Pulsed-radiofrequency (PRF) therapy in the management of chronic neurophatic pain due to a neuroma formation in a nephrostomy scar: a case report

Background and Aims A neuroma is a mass of nerve tissue that forms at a site of injury. They can be exquisitely tender when pressure is applied, leading to a loss of function by reducing both movement and contact with the affected area. Pulsed radiofrequency (PRF) is a novel technique that is safe and effective in the management of chronic pain syndromes. However, its effectiveness in treating conditions such as painful neuromas has not been fully elicited. We present a case of a gentleman treated with PRF for a neuroma that alleviated his symptoms of significant neuropathic scar pain. Methods We assessed this gentleman’s pain by assessing his Visual Analogue Scale (VAS), reviewed previous management strategies, current medication and impact of the condition on his life. A single session of ultrasound guided PRF was then delivered to the neuroma. Results A 66-year old gentleman presented with an 8-year history of persistent neuropathic pain in his right loin associated with a nephrectomy scar despite analgesic medication (oral and transdermal) and trigger point injections. Pain was 7/10 on the VAS scale with significant impact on the patient’s psychological wellbeing. After PRF, his pain score improved ceased analgesic medication and remained pain free at 18-month follow-up. Conclusions Neuropathic pain is a difficult condition to manage due to the biopsychosocial factors involved whereby diverse strategies may have to be utilized. PRF has been shown to be successful in the treatment of a painful neuroma following scar formation and so offers an alternative, medication-free approach to treating this condition.