Safety of combined exercise and spinal cord stimulation therapy in persistent spinal pain syndrome: a case report

A 36-year-old man with a history of lumbar disc herniation and laminectomy in 2022 presented with recurrent pain, despite initial improvement. His symptoms, likely attributable to postsurgical fibrosis and residual disc protrusion, were managed with various treatments, including pharmacological therapy, epidural steroid injection, and epidurolysis, albeit with limited success. Following a multidisciplinary evaluation, SCS was proposed, and the patient consented to the procedure. Diagnostic imaging revealed postsurgical changes and nerve root involvement at the L5-S1 level. The patient commenced a structured exercise program in conjunction with SCS, aimed at enhancing spinal stability and function, with positive outcomes anticipated through continued intervention. The current findings suggest that exercise, when following a standardised protocol, carries a minimal risk of electrode migration. However, further research is required to validate the reliability of these radiographic measurements. Future studies should focus on larger sample sizes and examine the combined effects of SCS and individualized exercise interventions. This could aid in the development of more effective and comprehensive treatment protocols for PSPS-T2 patients.