Authors' reply to the comment by Russo et al

DOI: 10.1002/ejp.1791 LETTER TO THE EDITOR Authors' reply to the comment by Russo et al Dear Editor, We would like to thank Dr. Russo and colleagues (Russo et al., 2021) for their interest in our publication (Pushparaj et al., 2021) and for their insightful comments. Dr. Russo and his colleagues are correct in stating our meta-analysis of seven RCTs did not show analgesic benefit of pulsed radiofrequency (pRF) neuromodulation for chronic shoulder pain over conservative medical management (CMM). As noted by Dr. Russo and colleagues, heterogeneity in ‘conventional medical management’ in the included studies was considerable. Though a meta-analysis that does not include the data from Eyigor study (Eyigor et al., 2010) may yield different results, we recommend focusing on the qualitative analysis of the results as summarized in the letter by Dr. Russo et al. Our objective in performing the systematic review and meta-analysis was to evaluate the role of radiofrequency procedures (ablative and neuromodulatory) performed for chronic shoulder pain that arises from the glenohumeral joint (GHJ) and the acromioclavicular joint. The complex structure and innervation of the shoulder joint, as compared to the knee and the hip joint, make it a challenging target for denervation. As stated in our publication, and as echoed by Dr. Russo and colleagues, adequately powered RCTs of a high quality that include procedures on the shoulder joint based on appropriate anatomical knowledge and address long-term functional outcomes are required. CONFLICT OF INTEREST None declared. Hemkumar Pushparaj1 Anuj Bhatia1,2 1622 | © 2021 European Pain Federation - EFIC® 1 Department of Anesthesia and Pain Management, University Health Network-Toronto Western Hospital and Women's College Hospital, University of Toronto, Toronto, ON, Canada 2 Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada Correspondence Anuj Bhatia, Department of Anesthesia and Pain Management, Toronto Western Hospital, McL 2-405, University Health Network, 399 Bathurst Street, Toronto, Ontario M5T 2S8, Canada. Email: [email protected] R E F E R E NC E S Eyigor, C., Eyigor, S., Korkmaz, O. K., & Uyar, M. (2010). Intraarticular corticosteroid injections versus pulsed radiofrequency in painful shoulder: A prospective, randomized, single-blinded study. Clinical Journal of Pain, 26(5), 386–392. https://doi.org/10.1097/ AJP.0b013e3181cf5981 Pushparaj, H., Hoydonckx, Y., Mittal, N., Peng, P., Cohen, S., & Bhatia, A. (2021). A systematic review of radiofrequency procedures on innervation to the shoulder joint for relieving chronic pain. Accepted for publication in the. European Journal of Pain, 25, 986–1011. Russo, M., Santarelli, D., Wright, R., & Beh, E. J. (2021). Comments on ‘a systematic review and meta-analysis of radiofrequency procedures on innervation to the shoulder joint for relieving chronic pain’ by Pushparaj et al European Journal of Pain, https://doi.org/10.1002/ejp.1783 How to cite this article: Pushparaj H, Bhatia A. Authors' reply to the comment by Russo et al. Eur J Pain. 2021;25:1622–1622. https://doi.org/10.1002/ ejp.1791 wileyonlinelibrary.com/journal/ejp Eur J Pain. 2021;25:1622.