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Author Spotlight: Methodologies and Advancements of Chronic Pain Management Research
Published on: January 5, 2024
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Neurostimulation for Chronic Pain: A Systematic Review of High-Quality Randomized Controlled Trials With Long-Term
Yilong Zheng1, Christopher Weiyang Liu2, Diana Xin Hui Chan2
1Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Summary
Neurostimulation therapies offer long-term chronic pain relief. Spinal cord stimulation (SCS) and other methods are recommended for various pain conditions, with closed-loop SCS showing superior results for back and leg pain.
Area of Science:
- Neurology
- Pain Management
- Medical Devices
Background:
- Chronic pain affects millions globally, necessitating effective long-term treatment strategies.
- Neurostimulation presents a promising therapeutic avenue for managing refractory chronic pain conditions.
Purpose of the Study:
- To systematically review the highest quality evidence on the long-term efficacy of neurostimulation for chronic pain.
- To identify specific neurostimulation modalities and their recommended applications for various chronic pain syndromes.
Main Methods:
- A systematic review of randomized controlled trials (RCTs) with at least one-year follow-up was conducted.
- Studies were sourced from PubMed, CENTRAL, and WikiStim, with quality assessed using the Delphi list criteria.
- Primary outcome was long-term pain intensity reduction; secondary outcomes included all other reported effects.
Main Results:
- Twenty-four high-quality RCTs were included, evaluating various neurostimulation techniques.
- Recommended therapies include pulsed radiofrequency (PRF), transcutaneous electrical nerve stimulation, motor cortex stimulation, deep brain stimulation, sphenopalatine ganglion stimulation, occipital nerve stimulation, peripheral nerve field stimulation, and spinal cord stimulation (SCS).
- Specific recommendations include closed-loop SCS over open-loop SCS for back/leg pain, SCS over PRF for postherpetic neuralgia, and dorsal root ganglion stimulation over SCS for complex regional pain syndrome.
Conclusions:
- Neurostimulation is an effective adjunctive treatment for long-term chronic pain management.
- Further research is needed to explore the integration of multidisciplinary pain management strategies, addressing physical, emotional, and social factors.
