Spinal cord stimulation in a patient with persistent oesophageal pain

This study describes a man with a long history of oesophageal pain that led to inability to swallow food and drink. Over a period of 8 years, he had multiple oesophageal operations that were unsuccessful. He presented, to the pain management team, with persistent oesophageal pain and required jejunostomy tube feeding to maintain nutrition. Conservative pain management strategies failed. Spinal cord stimulation (SCS) was suggested, and after counseling, an electrode was placed in the high thoracic region. Stimulation covered the area of the chest pain. He achieved immediate reduced pain on swallowing water. A permanent system was implanted. In this case, SCS resulted in a significant improvement in pain on swallowing liquids. The patient can now also eat certain foods occasionally and enjoy the social aspect of eating; this was impossible previously. He feels that SCS has been worthwhile. The authors discuss the rationale for this treatment. The decision was based on the use of SCS for refractory angina, and the idea that the neural mechanisms that generate both these pain states may be similar.