From the Guidelines
Spinal cord stimulation is the most dominant form of electrical stimulation used to treat pain, due to its widespread clinical implementation and established efficacy for various chronic pain conditions. This approach involves implanting electrodes in the epidural space to deliver electrical impulses that modify pain signals before they reach the brain. The dominance of spinal cord stimulation in pain management can be attributed to its relatively less invasive nature compared to intracerebral or PAG stimulation, as well as its reversibility 1.
Some of the key benefits of spinal cord stimulation include its potential to alleviate severe neuropathic pain of either malignant or non-malignant causes, and its applicability in cases where pain is difficult to control with pharmacological options 1. Additionally, advancements in technology have made it possible to carry out MRI scans if required, due to the availability of MRI-compatible spinal cord stimulation equipment 1.
While other forms of electrical stimulation, such as motor cortex stimulation, have specific applications for certain neuropathic pain conditions, spinal cord stimulation remains the cornerstone electrical neuromodulation approach for chronic pain management, with a significant amount of evidence supporting its efficacy and safety 1. The most recent guidelines and studies continue to support the use of spinal cord stimulation as a viable treatment option for patients with chronic pain, particularly those who have failed to respond to conservative approaches 1.
Key points to consider when evaluating the dominance of spinal cord stimulation include:
- Its widespread clinical implementation and established efficacy for various chronic pain conditions
- Its relatively less invasive nature compared to other forms of electrical stimulation
- Its reversibility and potential for alleviating severe neuropathic pain
- The availability of MRI-compatible equipment and advancements in technology
- The significant amount of evidence supporting its efficacy and safety, as reported in recent studies and guidelines 1.
From the Research
Dominant Form of Electrical Stimulation for Pain Treatment
- The most dominant form of electrical stimulation used to treat pain is Spinal Cord Stimulation (SCS), as evident from the studies 2, 3, 4, 5, 6.
- SCS is a widely used treatment for chronic pain, particularly for conditions such as failed back surgery syndrome, complex regional pain syndrome, and peripheral vascular disease.
- The mechanism of action of SCS is believed to involve the inhibition of pain signals to the brain, as well as the release of neurotransmitters that modulate pain perception 2, 5.
- Clinical studies have consistently shown that SCS is effective in reducing pain intensity and improving functional outcomes in patients with chronic pain, with success rates ranging from 50% to 70% 3, 5, 6.
- The use of SCS has been supported by cost-benefit analyses, which suggest that it is a cost-effective treatment option for patients with chronic pain who have failed to respond to other treatments 2.