Neuromodulation Treatment for Chronic Back Pain

Definition

Spinal cord stimulation system components.
Spinal cord stimulation system components. Getty Images News/Getty Images North America/ Getty Images

Neuromodulation Definition

Neuromodulation is a category of pain treatment that delivers either electricity or drugs to nerves in order to change their activity. Neuromodulation is an umbrella term that covers two main types of treatments (discussed below.) Both types address a variety of diseases and symptoms.

The wide range of ailments that can be addressed with neuromodulation includes:  Spinal cord damage, chronic back pain, headaches, and other types of chronic pain conditions such as complex regional pain syndrome,  Parkinson's disease, angina, and even deafness are also on this list.

Types of Neuromodulation

  • Neurostimulation: delivers electrical signals to the brain, spinal cord or nerves.  Word on the street (internet forums and social media groups) is that many people find relieve with this route with few complications. Also, as noted above, studies show that favorable results can be had from this type of neuromodulation
  • Implanted drug pumps: sometimes used as a last resort in pain management therapy for people with severe chronic back pain syndromes.  One big advantage of drug pumps is that the medication is delivered directly to the area that needs it, which allows for much lower doses.

Is Neuromodulation Safe and Effective?

Neuromodulation is regarded as a safe treatment, mainly because installing the equipment and monitoring it is a minimally invasive procedure, according to the Neuromodulation Appropriateness Consensus Committee in their August 2014 guideline.  (The guideline was published in the journal Neuromodulation.)

Most patients who turn to neuromodulation for pain relief have already been through conservative medical treatment with little or no luck. That said, one potential problem is a device-related complication.  The good news is the Committee reports that incidences of such issues are becoming less frequent, as technology advances and doctors' skills with neuromodulation continue to improve.

The Committee also reported that medical studies do support the effectiveness of neuromodulation for failed back surgery syndrome (FBSS.)

In 2012, Rigoard, et. al., studied 11 failed back surgery patients who had spinal cord stimulators implanted for pain relief.  The researchers wanted to see if newer type spinal cord stimulator leads, which were multi-column, tripolar, would completely relieve the patients’ back pain. They concluded that, indeed, neurostimulators are able to reliably generate coverage and good outcomes in terms of relief for chronic back pain patients.

A 2016 study also published in Neuromodulation confirmed the results and found that spinal cord stimulation is effective for not only pain relief, but disability, quality of life and satisfaction with the treatment, among other things.  The authors conclude that their study's findings further support the safety, effectiveness of spinal cord stimulation as a medical treatment for chronic back pain.

 

Source:

Deer T., et. al. Results From the Partnership for Advancement in Neuromodulation Registry: A 24-Month Follow-Up. Neuromodulation. Feb 2016. https://www.ncbi.nlm.nih.gov/pubmed/26890015

Deer TR, Mekhail N, Provenzano D, Pope J, Krames E, Leong M, Levy RM, Abejon D, Buchser E, Burton A, Buvanendran A, Candido K, Caraway D, Cousins M, DeJongste M, Diwan S, Eldabe S, Gatzinsky K, Foreman RD, Hayek S, Kim P, Kinfe T, Kloth D, Kumar K, Rizvi S, Lad SP, Liem L, Linderoth B, Mackey S, McDowell G, McRoberts P, Poree L, Prager J, Raso L, Rauck R, Russo M, Simpson B, Slavin K, Staats P, Stanton-Hicks M, Verrills P, Wellington J, Williams K, North R; Neuromodulation Appropriateness Consensus Committee. The appropriate use of neurostimulation of the spinal cord and peripheral nervous system for the treatment of chronic pain and ischemic diseases: the Neuromodulation Appropriateness Consensus Committee. Neuromodulation. August 2014.

Rigoard P1, Delmotte A, D'Houtaud S, Misbert L, Diallo B, Roy-Moreau A, Durand S, Royoux S, Giot JP, Bataille B. Back pain: a real target for spinal cord stimulation? Neurosurgery. May 2012.

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