Efficacy and Safety of Pulsed Radiofrequency Combined with Platelet-Rich Plasma in the Treatment of Postherpetic Neuralgia - A Systematic Review and Meta-Analysis

Sep 29, 2026

Uploaded by Jacob

Herpes zoster-associated neuralgia (HZN) results from reactivation of latent varicella-zoster virus within spinal nerves and substantially reduces patients’ quality of life. This systematic review and meta-analysis evaluates whether pulsed radiofrequency (PRF) combined with platelet-rich plasma (PRP) improves efficacy and safety for postherpetic neuralgia versus PRF alone. Outcomes include postoperative pain intensity, sleep quality, rescue analgesic use, and adverse events, based on seven studies.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Background

Methods

Results

Conclusion

Introduction

Current Treatment Options for HZN

Journal of Pain Research Open Access Full Text Article REVIEW Efficacy and Safety of Pulsed Radiofrequency Combined with Platelet-Rich Plasma in the Treatment of Postherpetic Neuralgia: A Systematic Review and Meta-Analysis Ziwei Lu 1 , 2 , Chengcheng Zhao 1 , 2 , Huadong Ni 2 , Ming Yao 2 1Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China; 2Department of Anesthesiology and Pain Research Center, The Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, People’s Republic of China Correspondence: Huadong Ni; Ming Yao, Email [huadongni@126.com](huadongni@126.com); [jxyaoming@zjxu.edu.cn](jxyaoming@zjxu.edu.cn) | Background: Herpes zoster-associated neuralgia (HZN) is a disease caused by the reactivation of the varicella-zoster virus (VZV) that is latent within the spinal nerves, with a major impact on patients’ quality of life. The objective of this study is to evaluate the efficacy and safety of Pulsed Radiofrequency (PRF) combined with Platelet-Rich Plasma (PRP) in the treatment of HZN, comparing it with PRF alone.
Methods: A thorough search was conducted on multiple databases. Several clinical studies from the inception of each database up to December 2024 were included in the study. The primary clinical outcome was the postoperative pain intensity score. Secondary clinical outcomes encompassed sleep quality, the utilization of rescue analgesics postoperatively, and the incidence of adverse events. Results: The final analysis incorporated a total of seven studies, encompassing 568 subjects. With regard to the alleviation of pain, PRF combined with PRP therapy has shown more significant pain relief for HZN when compared with conventional PRF therapy. The combination of PRF and PRP therapy has been demonstrated to be more efficacious in enhancing patients’ sleep quality. With regard to the administration of postoperative rescue analgesics, the dosage of such medication was found to be lower in cases where PRF was combined with PRP therapy. The incidence of adverse events was consistent across both groups.
Conclusion: The PRF-PRP is more effective than the traditional radiofrequency pulse therapy in treating HZN. This combination has been demonstrated to enhance sleep quality and reduce the necessity for postoperative rescue analgesics. The potential for this approach extends to its utilization as a novel therapeutic modality for HZN.
Keywords: herpes zoster, postherpetic neuralgia, pulsed radiofrequency, platelet-rich plasma | | --- | | Introduction
Herpes zoster (HZ) is a skin disease caused by the infection of the spinal cord and cranial nerves by the varicella-zoster virus (VZV) . It is characterized by vesicular eruptions along the affected dermatomes, accompanied by burning, stabbing pain.1 The annual incidence of HZ ranges from 4.28/1000 person-years across all age groups, with a higher incidence observed in elderly patients due to declining immunity.2 The classification of HZN is as follows: acute herpes zoster neuralgia (AHN; within 1 month post-rash), subacute herpes zoster neuralgia (SHN; within 3 months post-rash), and post herpetic neuralnia (PHN; beyond 3 months post-rash) .3 Postherpetic neuralgia (PHN) has been identified as the most common and severe complication of shingles.4 Consequently, there is a necessity to proactively investigate efficacious therapeutic methodologies with a view to enhancing the management of pain and reducing the prevalence of HZN, thus leading to an enhancement in patients’ quality of life.
Current treatment options for HZN encompass pharmacological interventions, nerve blocks, and minimally invasive surgical interventions.5 Pharmacological treatment is frequently regarded as the primary intervention for patients in the | Received: 4 July 2025 Accepted: 23 December 2025 Published: 30 December 2025 Journal of Pain Research 2025:18 7213–7224 7213 © 2025 Lu et al. This work is published and licensed by Dove Me

FAQs

What was the primary objective of this study?

To evaluate the efficacy and safety of pulsed radiofrequency (PRF) combined with platelet-rich plasma (PRP) for HZN, compared with PRF alone.

What were the primary and secondary clinical outcomes?

Primary outcome was postoperative pain intensity score. Secondary outcomes included sleep quality, postoperative rescue analgesic utilization, and incidence of adverse events.

How did PRF combined with PRP compare with PRF alone?

The combination showed more significant pain relief, improved sleep quality, and reduced postoperative rescue analgesic dosage, while adverse event incidence was consistent across groups.

Sep 29, 2026

Uploaded by Jacob