Neuromodulation for central pain

Central pain, which follows brain and spinal cord injury remains an ill-treated entity affecting approximately 1-2 million people worldwide. When oral drugs fail, either immediately or in the long run, the only therapeutic option is neuromodulation, via either electrical or chemical means. The whole spectrum of neuromodulatory techniques for central pain is poorly appreciated by pain therapists. Results of all these techniques provide rational guidelines for the treating physician and are detailed in this review. Reviewed techniques include cortical, deep brain and spinal cord stimulation, transcutaneous electrical nerve stimulation, electroconvulsion, and pump infusion of intrathecal drugs.