Spinal cord stimulation in chronic pain management

Meglio, Mario

doi:10.1016/j.nec.2004.02.012

Cited by 10 publications

(4 citation statements)

References 62 publications

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“…Direct surgical approaches to the nerve lesion and spinal ablative procedures have shown limited efficacy in long term follow‐up (9). SCS on the other hand has shown promising results for treating neuropathic pain conditions such as complex regional pain syndrome, peripheral nerve lesions, and phantom limb pain (10–16). On the basis of experimental findings some authors (17) have proposed that in pain associated with signs of neuropathy of peripheral origin, SCS could produce pain relief by a suppressive effect on the hyperexcitability of the dorsal horn neurons of the wide dynamic range type.…”

Section: Discussionmentioning

confidence: 99%

Spinal Cord Stimulation in the Management of Pain from Brachial Plexus Avulsion

Piva

Shaladi

Saltari

et al. 2003

Neuromodulation: Technology at the Neural Interface

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Section: Discussionmentioning

confidence: 99%

Spinal Cord Stimulation in the Management of Pain from Brachial Plexus Avulsion

Piva

Shaladi

Saltari

et al. 2003

Neuromodulation: Technology at the Neural Interface

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“…SCS has been so effective for intractable chronic pain syndromes that every pain center should be able to offer this therapy in its treatment program. Many prominent pain centers will consider SCS for every patient with nonmalignant chronic pain that has not come under control with more conservative treatments [72]. For most patients, temporary leads can be placed percutaneously for up to 10 days to provide a trial of the effects of stimulation on pain.…”

Section: Spinal Cord (Dorsal Column) Stimulationmentioning

confidence: 99%

Neurophysiological Underpinnings of Electronic Analgesic Neuromodulation for Dummies

Brookoff

2006

Pain Med

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Electronic neuromodulation can be a safe and effective treatment for intractable pain. Unfortunately, many physicians and other healthcare providers know nothing of neuromodulatory techniques. There is little opportunity to learn about them in medical school or during general medical training. Nearly all of the literature about neuromodulation is aimed at specialists who already have a detailed knowledge of the field. This article reviews the pathophysiology of chronic pain from the point of view of a primary care practitioner, with the aim of providing a rationale for the appropriate use of electronic neurostimulators in patients with chronic pain. In order to understand advanced pain management, it is important to first understand that pain management is not about treating pain, but about "reducing hypersensitivity." Specifically, advanced pain management techniques are aimed at the pathophysiological processes of hyperalgesia, allodynia, neurogenic inflammation, and neural remodeling. Some approaches to electronic analgesic neuromodulation are summarized.

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“…Spinal cord stimulation (SCS) continues to gain attention as a treatment for a variety of chronic pain concerns [1], and is approved by the U.S. Food and Drug Administration for chronic pain of the trunk and limbs, pain from “failed” back surgery syndrome, and intractable low back pain [2]. Studies examining SCS treatment for Complex Regional Pain Syndrome) type I (CRPS-I) have paralleled those of SCS treatment of back pain, with stimulation resulting in improvements in pain [3–6] up to 2 years post-implantation [7], but not after 3 years [8].…”

Section: Introductionmentioning

confidence: 99%

Chronic Pain Rehabilitation for Upper Extremity Pain Following Stimulator Removal

et al. 2018

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Patient: Female, 26Final Diagnosis: Complex Regional Pain Syndrome (CRPS)Symptoms: Edema • pain • sweatingMedication: —Clinical Procedure: —Specialty: General and Internal MedicineObjective:Unusual or unexpected effect of treatmentBackground:Both spinal cord stimulators (SCS) and interdisciplinary chronic pain rehabilitation program (CPRP) are evidence-based treatments for chronic pain but differ on treatment foci. SCS focuses on decreasing the subjective pain experience as a means of improving function and quality of life. CPRP focuses on addressing the cognitive, emotional, and behavioral factors associated with chronic pain to improve function. Due to experimental constraints, these 2 treatment options are difficult to compare; however, this case report offers a unique opportunity to examine outcomes for both interventions in a sequential manner for changes in pain, function, and mood.Case Report:This single case study examined the separate and sequential outcomes of SCS and CPRP in a 26-year-old patient with a work-related injury resulting in chronic upper extremity pain. This patient was treated within an interdisciplinary CPRP following failure and removal of an SCS. Outcomes were measured by psychological assessments and return-to-work through a 6-month post-CPRP follow-up.Conclusions:Pain intensity decreased following SCS placement and CPRP, while pain-related distress, pain interference, and overall affect improved only after CPRP, with sustained improvements at 6-month follow-up. Patient evidenced improvement following treatment with SCS and CPRP. SCS resulted in improvement in subjective pain and modest improved self-reported activity. CPRP demonstrated marked improvement in pain, self-reported function, and mood with patient eventually returning to work and maintaining most of these gains 6-months after completing CPRP treatment.

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Spinal cord stimulation in chronic pain management

Cited by 10 publications

References 62 publications

Spinal Cord Stimulation in the Management of Pain from Brachial Plexus Avulsion

Spinal Cord Stimulation in the Management of Pain from Brachial Plexus Avulsion

Neurophysiological Underpinnings of Electronic Analgesic Neuromodulation for Dummies

Chronic Pain Rehabilitation for Upper Extremity Pain Following Stimulator Removal

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