Chronic low back pain is a condition that current health care provision is failing and we suggest that recent evidence from the interventional pain medicine field points to what these failings are. Radiofrequency denervation is performed on the presumption that denervation of a peripheral structure will eradicate or significantly reduce pain and improve function. The results of six moderately sized and well conducted clinical trials that demonstrate no efficacy and no real-world effectiveness for denervation procedures are a stark illustration of how flawed this approach is. We suggest that these results represent a line-in-the-sand for back pain research and management. This is a clear signal to finally abandon research agendas and management paradigms that focus primarily on nociception and instead, truly embrace the biopsychosocial model of pain.


back pain, clinical trials, radiofrequency denervation, interventional pain medicine, evidence-based medicine

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