Editor-in-Chief: Alaa Abd-Elsayed, MD, PhD
BACKGROUND: Thermal modulation exploits phase shift and was previously examined for proof of concept in the animal model. We aimed to generate nerve blocks similarly in humans at moderate nerve temperatures in a nondestructive manner. We examined patients who experienced a traumatic mechanism of injury followed by debilitating positional headache, suspicious for cerebrospinal fluid (CSF) leak.
CASE REPORT: Thermal modulation may be helpful in treating painful conditions of areas of superficial peripheral nerves as they are easily targeted by application of heat and cold to the skin. We applied the protocol to patients with traumatic cervical syndrome and headaches secondary to CSF leak. Using the therapy as an abortive measure reduced scores on the Numeric Rating Scale (NRS-11) for pain in both patients by 88%. One patient experienced long-term relief after consistent use of the therapy.
CONCLUSION: The thermal modulation technique may be effective in targeting superficial nerves and can be useful in treating difficult headache conditions resulting from traumatic injury.
KEY WORDS: Low pressure syndrome, CSF leak, secondary headache, thermal modulation, thermal nerve block