Ankylosing spondylitis management: a narrative review of radiofrequency ablation and naproxen

Axial spondyloarthritis (axSpA) is a chronic inflammatory disease primarily affecting the spine and sacroiliac joints, causing pain, stiffness, and reduced mobility. Its pathophysiology remains unclear, complicating treatment development. Management aims to alleviate symptoms and control inflammation, but targeted strategies are lacking. This study compared the efficacy of radiofrequency ablation (RFA) and naproxen in axSpA treatment. A PubMed search was conducted on 14 March 2023 and 27 May 2025. RFA is a minimally invasive procedure that targets nerve endings to block pain signals, while naproxen is a non-steroidal anti-inflammatory drug (NSAID) that reduces inflammation. We conducted a narrative review of axSpA patients treated with either RFA or naproxen, assessing pain relief, functional improvement, and quality of life. Results showed that RFA was significantly more effective than naproxen in managing chronic pain. Patients receiving RFA reported greater pain reduction and better functional outcomes compared to those on naproxen. RFA provided prolonged relief, while naproxen's effectiveness diminished over time, limiting its long-term benefit. These findings suggest that RFA should be considered a preferred treatment for axSpA patients seeking long-term pain relief and improved quality of life. This study supports RFA's role in managing inflammatory spinal conditions and informs optimal axSpA treatment strategies.