Spring2® is a Pulsed Radiofrequency (PRF) generator designed specifically for transcutaneous procedures – entirely without a needle. It is the solution for patients seeking effective joint and nerve pain treatment without punctures and without the risk of invasive complications.

Treatment time: 15–30 minutes • Protocol: 3 sessions every 1–3 weeks

What is the Spring2® Transcutaneous PRF Procedure?

Transcutaneous Pulsed Radiofrequency (TcPRF, also known as STP – Superficial Transcutaneous PRF) is a non-invasive form of the PRF method, proven for over 25 years, developed by Prof. Menno Sluijter. The procedure involves attaching special Springlife® gel electrodes to the skin, through which the Spring2® device emits short pulses of radio waves at 420 kHz.

The mechanism of action is bidirectional. First, the electromagnetic pulses reach subcutaneous nerve endings and modulate the conduction of pain signals – they do not destroy nerve fibres, but ‘reset’ their hypersensitivity. Second, the radiofrequency waves act at the cellular level of inflamed tissues (known as immunoPRF according to Sluijter’s classification): they influence T lymphocytes and immune system cells, reducing oxidative stress and inhibiting the pro-inflammatory cytokine cascade. Tissue temperature never exceeds the threshold of thermal destruction (duty load: 15 ms per second – 3 series of 5 ms).

What Distinguishes Spring2® from Conventional RF Generators?

  •  Automatic electrode identification – the device recognises the size of the attached plates (S/M/L) and automatically limits the maximum output current to values safe for that surface area.
  • Up to 4 electrodes can be used simultaneously – allowing the entire joint or several trigger points to be covered in one session.
  • Operating frequency 420 kHz, amplitude 0.2–4.8 A – parameters optimised for TcPRF based on Sluijter’s protocol (2023).
  • Non-invasive procedure – no punctures, no risk of haematoma, no recovery period.

Indications – When Should TcPRF Spring2® Be Considered?

Transcutaneous thermolesion is particularly effective for pain with an inflammatory basis. The most common clinical indications include:

  • Degenerative disease of the knee joint (gonarthrosis)
  • Frozen shoulder syndrome (capsulitis adhesiva)
  • Hip joint pain (coxarthrosis)
  • Tennis elbow and golfer’s elbow (enthesopathy of the epicondyle)
  • Lumbar spine pain of discogenic nature (confirmed efficacy in published case series – Sluijter et al. 2023)
  • Sciatica and cervicobrachial neuralgia – as a complement or alternative to invasive therapy
  • Post-operative pain, especially after arthroplasty
  • Chronic inflammatory conditions of ligaments and tendons
  • Patients for whom invasive procedures are contraindicated (e.g. those on anticoagulants)

Step-by-Step Procedure

  • Qualifying consultation – a pain medicine physician evaluates medical history, imaging studies (MRI/X-ray/ultrasound) and establishes the therapy protocol.
  • Electrode positioning – depending on the location of pain, 2–4 Springlife® electrodes of different sizes (5.5×5.5 cm; 6×12 cm; 8×15 cm) are applied to the skin.
  • PRF session – the actual procedure lasts 15–30 minutes. The patient feels only a gentle, warm tingling sensation with no pain.
  • Immediately after the session the patient returns to normal activity – there are no contraindications to driving or physical exertion.
  • A full treatment cycle consists of 3 sessions at 1–3 week intervals, following the four-phase PRF effect pattern (start phase → transition phase → effective phase lasting 6–24 months).

Preparation for the Procedure

  • No need to fast
  • Skin at the electrode application site should be clean, shaved and free of inflammatory lesions
  • The physician should be informed of all medications being taken (especially anticoagulants – though these are not an absolute contraindication)
  • Absolute contraindication: cardiac pacemaker, cardioverter-defibrillator, other active electronic implants, pregnancy

Effects – What to Expect?

Effects develop gradually, according to four phases described by Prof. Sluijter:

  • Phase 1 (‘stunning’) – immediate relief lasting 2–3 days
  • Phase 2 (transitional) – possible temporary return of symptoms for approximately 3 weeks
  • Phase 3 (effective) – actual pain reduction, lasting from 6 to 24 months, and in some patients longer
  • Phase 4 – possible return of symptoms; the cycle can be safely repeated as PRF does not damage nerves

Full assessment of effectiveness is possible 6–8 weeks after completing the cycle. Individual response to therapy depends on the degree of pathological changes and the aetiology of pain.

Possible Side Effects

  • Transient skin redness at the electrode application site (resolves spontaneously within a few hours)
  • Brief pain intensification in Phase 2 (a biological effect, not a complication)
  • Very rarely – contact allergy to the gel electrode material
  • No risk of complications typical of invasive procedures (haematoma, infection, nerve damage)

FAQ – Frequently Asked Questions

How does TcPRF Spring2® differ from classical thermolesion?

Classical thermolesion (RFA) is performed with a needle at 60–90°C and deliberately destroys the nerve. TcPRF Spring2® is entirely non-invasive – electrodes are placed on the skin, tissue temperature remains safe and nerves are not damaged. It works through modulation, not destruction.

How many sessions are needed?

The standard protocol is 3 sessions at 1–3 week intervals. In some patients the very first session brings significant relief, but the full biological effect develops only after the cycle is complete.