PENG Block & PENG PRF

Overview

The primary aim of this study is to prospectively compare the effects of the pericapsular nerve group (PENG) block alone and the combination of PENG block with pulsed radiofrequency (PRF) on pain intensity in patients with chronic hip pain. As a secondary aim, the effects of both treatment modalities on hip function are intended to be evaluated using valid and reliable functional assessment scales. Through this study, it is aimed to demonstrate the clinical contribution of adding PRF to the PENG block and to identify a more effective and longer-lasting approach for the interventional treatment of chronic hip pain.

Chronic hip pain is a common clinical condition, particularly in the elderly, that significantly impairs quality of life and leads to functional limitation and dependence in daily activities. Chronic hip pain caused by degenerative, inflammatory, and mechanical conditions-most notably hip osteoarthritis-often remains inadequately controlled despite medical treatment, physical therapy, and rehabilitation. Although surgical interventions can be effective, they are not suitable for all patients due to advanced age, comorbidities, or surgical contraindications. Therefore, minimally invasive interventional pain management techniques have gained increasing importance in the treatment of chronic hip pain. The nociceptive innervation of the hip joint primarily arises from the anterior capsule, which is mainly supplied by the sensory branches of the femoral, obturator, and accessory obturator nerves. Based on this anatomical rationale, the pericapsular nerve group (PENG) block is an ultrasound-guided technique that targets these sensory fibers to provide effective analgesia without causing motor blockade. Previous studies have shown that the PENG block reduces pain scores and improves functional mobility in both acute and chronic hip pain; however, its analgesic effect may be time-limited, requiring repeated applications in some patients. Pulsed radiofrequency (PRF), unlike conventional thermal radiofrequency, aims to modulate nerve transmission without causing tissue destruction and may provide longer-lasting analgesia through neuromodulatory mechanisms. Recent evidence suggests that combining PRF with peripheral nerve blocks may prolong analgesic effects compared with nerve blocks alone. However, prospective studies directly comparing PENG block alone with PENG block combined with PRF in chronic hip pain are limited, highlighting the need for further investigation.