Patients who live with relentless neuropathic pain have traditionally had few options for relief. Neuropathic pain is caused by damage or disease to the nervous system, and results in pain coming in response to stimuli that wouldn’t bother another person.
For some people this pain is a constant while for others it happens in episodes that feel like electric shocks: in all cases it significantly interferes with the person’s quality of life.
The two available options that exist for relief of chronic neuropathic pain are drug therapy and spinal cord stimulation involving the implantation of a device in the body, a minimally invasive surgical procedure.
A recently released study has revealed that this procedure provides a far greater chance of pain reduction than does medication. The relief offered has also been shown to superior.
Though there have been earlier studies that have also yielded these results, this study represents a much larger group of patients than has previously been conducted. According to study author Tim J. Lamer, MD, professor of anesthesiology at the Mayo Clinic College of Medicine and Science, the results looked at 12 key randomized controlled trials that included 1080 patients.
The trials that were reviewed compared medical therapies including gabapentin, tricyclic antidepressants, and opioids and a variety of spinal cord stimulation types, including conventional stimulation using relatively low frequencies and low pulse-wave stimulation and newer modes of neuromodulation that include high-frequency stimulation, dorsal root ganglion stimulation, and burst stimulation that delivers closely spaced, high-frequency currents.
The researchers looked at patient results in terms of both level of pain relief and the existence of pain relief in order to compare the interventions, which showed that in three trials, spinal stimulation significantly increased the odds of reducing pain by 50% or more compared with medical therapy, while in three other trials, stimulation compared with medical therapy significantly reduced pain.
Newer technology provided a greater chance of pain relief than conventional stimulation.
Mews that spinal cord stimulation provides more effective and reliable pain relief than medication is good news, especial as opioid use is increasingly being discouraged.
Discussing the study’s results, Dr. Lamer said, “Opioids don’t work very well for patients with nerve-related pain and yet many patients are treated with these drugs. On the other hand, spinal cord stimulation has been shown to work quite well for many types of neuropathic pain.” He also said that it is more cost effective. “Ten years of medical therapy is extraordinarily expensive.”
The process of implanting a spinal cord stimulator is done in two steps. In the first step, the patient is fitted with a trial implant that has an external control device, then walks around with the device for a few weeks to determine whether it is providing effective pain relief. If the stimulation provides an improved quality of life a permanent spinal cord stimulator is implanted, with a pulse generator placed in either the buttocks or abdomen and a wireless control unit provided that can be programmed and managed externally.
For more information about whether a spinal cord stimulator is an appropriate answer for your symptoms, contact us today to set up an appointment.