02/05/2026
Study Alert
⚡ Efficacy and Safety of Pulsed Radiofrequency Combined with Platelet-Rich Plasma for Postherpetic Neuralgia. A Systematic Review and Meta-Analysis.
Background
Herpes zoster–associated neuralgia (HZN) results from reactivation of latent varicella-zoster virus within spinal nerves, leading to persistent inflammation, neuronal injury, and peripheral/central sensitization, with a major impact on quality of life. While pulsed radiofrequency (PRF) is an established interventional option, a subset of patients experience suboptimal pain relief or progression to postherpetic neuralgia (PHN).
Rationale for Combination Therapy
✓ PRF modulates pain at a microscopic/subcellular level by regulating synaptic plasticity, suppressing ectopic discharges, and enhancing descending inhibitory pathways
✓ PRP provides neuroprotective, anti-inflammatory, analgesic, and immunomodulatory effects via growth factor release, supporting tissue repair and neural recovery
Methods 🔬
✓ Systematic search of multiple databases
✓ Clinical studies included from database inception through December 2024
✓ Primary outcome: postoperative pain intensity
✓ Secondary outcomes: sleep quality, rescue analgesic use, and adverse events
Results 📊
• 7 studies included
• 568 patients analyzed
• PRF + PRP produced significantly greater pain reduction compared with PRF alone
• No significant pain difference at 1 week; superior pain relief at 2, 4, 8, and 12 weeks
• Consistent improvement in sleep quality at all follow-up intervals
• Reduced postoperative rescue analgesic requirements
• No increase in adverse events, with comparable safety profiles between groups
Conclusion 📌
The combination of PRF and PRP is more effective than PRF alone for the management of postherpetic neuralgia, providing superior pain control, improved sleep quality, and reduced reliance on rescue analgesics- without compromising safety. These findings support PRF + PRP as a promising and well-tolerated therapeutic strategy for shingles-related neuropathic pain.
🔗 https://doi.org/10.2147/JPR.S548797