Transcutaneous Pulsed Radiofrequency in Chronic Pain: A Systematic Review of Randomized Controlled Trials

INTRODUCTION: Transcutaneous pulsed radiofrequency (TcPRF) is a non-invasive neuromodulation technique increasingly investigated for the management of chronic pain. However, its clinical efficacy and safety across different chronic pain conditions remains uncertain. METHODS: A systematic search of PubMed, Scopus, and Google Scholar was performed from database inception to March 2026. Randomized controlled trials (RCTs) evaluating TcPRF in chronic pain conditions were included. Pain intensity, functional outcomes, and safety data were extracted. Risk of bias was assessed using the Cochrane RoB 2 tool. RESULTS: Eight RCTs were included, encompassing both musculoskeletal and neuropathic pain conditions. TcPRF was associated with reductions in pain intensity in most studies, with more consistent effects observed in sham-controlled trials and at later follow-up time points. Functional outcomes generally improved in parallel with pain, although results varied depending on the outcome measures used. TcPRF was well tolerated, with no serious adverse events reported. However, substantial heterogeneity was noted in patient populations, comparator interventions, treatment protocols, and outcome measures. CONCLUSION: TcPRF appears to be a promising non-invasive treatment option for selected chronic pain conditions, particularly when a minimally invasive approach is preferred. Nevertheless, current evidence remains limited by heterogeneity and methodological variability. Further large-scale, well-designed RCTs with standardized treatment protocols and longer follow-up are required to clarify its clinical role.