Spinal Cord Stimulators, Advances? A Revolution? How about a lot more research first?


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The new issue of Practical Pain Management has a lead article on Spinal Cord Stimulators, stressing early treatment, a revolution using “new [and] different patterns of electric stimulation.” Advances?

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I don’t have the energy or time to compare these new claims with the information just posted on this site from the International Association for the Study of Pain that details existing evidence with the decades of claims by these companies and abysmal lack of research. Perhaps they could set aside some of the billions in profit they use for PR and give us good research data.

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Chronic pain would make any of us vulnerable to risk our lives for these devices. Research is desperately needed. Here are the new claims:

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Recent Advances

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Ivano Dones, MD, and Vincenzo Levi, MD, of the Functional Neurosurgery Department at the Carlo Besta Neurological Institute in Milan, Italy, highlight “an ongoing revolution” in the treatment of neuropathic pain using “new [and] different patterns of electric stimulation.”3

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Conventional SCS stimulation employs a tonic waveform in which electrical pulses are delivered at a constant frequency, pulse width, and amplitude. It has been found effective for approximately 50% of neuropathic pain patients.4 To help more sufferers, including those who develop a tolerance to conventional stimulation, the researchers say that new types and patterns of stimulation, such as burst and high frequency, should be considered.

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To date, only small studies have been performed on burst stimulation, but Drs. Dones and Levi say the results have been promising. “When compared to conventional SCS,” they state, “burst stimulation gave remarkable long-term pain higher suppression.” In addition to providing greater pain control than the traditional tonic pattern, it was also associated with a decreased incidence of paresthesia (a pins-and-needles sensation).

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Studies have also shown that burst stimulation may be more effective in reducing pain in the axial midline region, an area that conventional tonic stimulation often fails to treat effectively.5 Dr. Dones told PPM that this is because “burst stimulation can recruit more nerve fibers in the spinal cord, thus interfering with their transmission of pain to the brain.”

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The authors cite a small study using high-frequency stimulation that showed 70% of patients “experienced a significant and sustained low back pain and leg pain relief.”6 They note, however, that another study showed no significant difference between the high-frequency mode and a placebo. More studies need to be conducted, they say.

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Joshua Rosenow, MD, director of Functional Neurosurgery and Epilepsy Surgery at Northwestern Medicine in Chicago, IL, applauds these recent advances. New patterns of stimulation, including combinations, he says, “have allowed us to provide a wider population of patients with a significant amount of pain relief.” They have also enabled clinicians to “more precisely match the therapy to the patient,” both now and as pain changes over time.

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The material on this site is for informational purposes only.

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It is not legal for me to provide medical advice without an examination.

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

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Comments are welcome.

This site is not for email, not for medical questions, and not for appointments.

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For My Home Page, click here:  Welcome to my Weblog on Pain Management!

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