She was given lifestyle advice including wearing loose clothing and to avoid wearing a belt. After a physiotherapy review, stretching and strengthening exercises were advised. Pregabalin was initiated and provided some degree of symptom relief.
However, the persistent discomfort, especially during flare-ups, prompted consideration of interventional pain relief methods. Given the chronicity and severity of her symptoms, a decision was made to perform pulsed radiofrequency (PRF) denervation of the LFCN.
The patient underwent bilateral PRF denervation under ultrasound guidance.
Aseptic precautions were taken, including sterile gloves, gown, and chlorhexidine spray for preparation. A 22-gauge, 10 cm RF needle was inserted under ultrasound guidance to target the LFCN.
PRF parameters: 6 minutes at 20 ms, 2 Hz, 42°C, and 45 V.
Medications administered: 10 ml of 0.25% bupivacaine and 80 mg methylprednisolone acetate per nerve.
Post-procedure care: Water resistant spray on dressing was applied, and no immediate complications were noted.
The success of the procedure in this case will be evaluated at follow-up, focusing on the patient’s pain scores and return to physical activities.
