Neurophysiology Research

All submissions of the EM system will be redirected to Online Manuscript Submission System. Authors are requested to submit articles directly to Online Manuscript Submission System of respective journal.
Reach Us +1 (629)348-3199

Mini Review - Neurophysiology Research (2023) Volume 5, Issue 3

Neurostimulation therapies for chronic pain: Surgical approaches and outcomes

Andrew Desuaiza*

Department of Medicine, University of Toronto, Toronto, Canada

*Corresponding Author:
Andrew Desuaiza
Department of Medicine
University of Toronto, Toronto, Canada
E-mail: dezandrew@mail.utoronto.ca

Received: 18-May-2023, Manuscript No. AANR-23-103729; Editor assigned: 20-May-2023, PreQC No. AANR-23-103729(PQ); Reviewed: 03-Jun-2023, QC No. AANR-23-103729; Revised: 06-Jun-2023, Manuscript No. AANR-23-103729(R); Published: 13-Jun-2023, DOI: 10.35841/aanr-5.3.146

Citation: Desuaiza A. Neurostimulation therapies for chronic pain: Surgical approaches and outcomes. Neurophysiol Res. 2023; 5(3):146

Visit for more related articles at Neurophysiology Research

Introduction

Neurostimulation therapies are a promising approach for managing chronic pain when other treatments have been ineffective. These therapies involve delivering electrical or magnetic impulses to specific nerves or areas of the brain to modulate pain signals. Here are a few neurostimulation therapies commonly used for chronic pain. Chronic pain affects millions of people worldwide, significantly impacting their quality of life and overall well-being. Conventional treatments for chronic pain, such as medications and physical therapy, may not always provide sufficient relief. In such cases, neurostimulation therapies have emerged as a promising alternative. Neurostimulation involves the use of electrical impulses to modulate the nervous system and alleviate pain. Surgical approaches to neurostimulation therapies have shown significant success in managing chronic pain and improving patients' outcomes [1].

One commonly used neurostimulation therapy is Spinal Cord Stimulation (SCS). This surgical procedure involves the placement of a small device, similar to a pacemaker, under the skin. Thin wires with electrical leads are inserted into the epidural space near the spinal cord. These leads deliver low-intensity electrical pulses that interfere with pain signals, thus reducing the perception of pain. The patient can control the intensity and pattern of the electrical stimulation using an external remote. Numerous studies have demonstrated the efficacy of SCS in treating various chronic pain conditions, including failed back surgery syndrome, complex regional pain syndrome and neuropathic pain. A randomized controlled trial published in the New England Journal of Medicine reported that SCS provided superior pain relief compared to conventional medical management in patients with failed back surgery syndrome. The study found that SCS reduced pain scores by at least 50% in 48% of patients, significantly improving their quality of life. Another surgical approach to neurostimulation therapy is Deep Brain Stimulation (DBS). DBS involves the implantation of electrodes in specific regions of the brain that are involved in pain processing. These electrodes are connected to a neurostimulation device, typically implanted under the collarbone, which delivers controlled electrical pulses. By modulating the activity of targeted brain areas, DBS can alleviate chronic pain [2, 3].

DBS has shown promising results in the management of intractable pain conditions, such as chronic neuropathic pain and central post-stroke pain syndrome. A study published in the Journal of Neurosurgery reported significant pain relief in patients with central post-stroke pain syndrome following DBS. The study found that DBS reduced pain intensity by 59% and 70% of patients experienced at least a 50% reduction in pain. While neurostimulation therapies offer a promising solution for chronic pain, it is essential to consider the potential risks and complications associated with these surgical approaches. Surgical site infections, lead migration and hardware malfunction are among the possible complications. However, the overall incidence of severe complications is relatively low and most can be managed with appropriate medical intervention [4].

In addition to surgical considerations, patient selection plays a crucial role in determining the success of neurostimulation therapies. A comprehensive evaluation by a multidisciplinary team, including neurologists, pain specialists and psychologists, is necessary to identify suitable candidates. Factors such as the type and duration of pain, psychological profile and response to trial stimulation should be carefully assessed. It's important to note that neurostimulation therapies are typically considered after conservative treatments have failed. The effectiveness of these therapies can vary depending on the individual and the specific pain condition. A thorough evaluation by a pain specialist is necessary to determine if neurostimulation is a suitable option and to guide the selection of the most appropriate therapy [5].

Conclusion

Neurostimulation therapies, particularly spinal cord stimulation and deep brain stimulation, have emerged as effective surgical approaches for managing chronic pain. These therapies have shown significant success in improving pain relief and enhancing the quality of life for patients with various chronic pain conditions. While surgical interventions present certain risks, the benefits of neurostimulation therapies outweigh the potential complications. Proper patient selection and comprehensive evaluation are crucial for optimizing outcomes. As research and technology continue to advance, neurostimulation therapies hold great promise in alleviating chronic pain and improving the lives of millions of individuals worldwide.

References

  1. D’Ostilio K, Magis D. Invasive and non-invasive electrical pericranial nerve stimulation for the treatment of chronic primary headaches. Curr Pain Headache Rep. 2016;20:1-9.

    2. Indexed at, Google Scholar, Cross Ref

  2. Deer T, Masone RJ. Selection of spinal cord stimulation candidates for the treatment of chronic pain. Pain Med. 2008;9:82-92.

    3. Indexed at, Google Scholar, Cross Ref

  3. Nizard J, Lefaucheur JP, Helbert M, et al. Non-invasive stimulation therapies for the treatment of refractory pain. Discov Med. 2012;14(74):21-31.

    4. Indexed at, Google Scholar

  4. O'Halloran KD. A shock to the system: neurostimulation therapy for opioid‐induced respiratory depression. J Physiol. 2022;600(12):2833.

    5. Indexed at, Google Scholar, Cross Ref

  5. Walter M, Sammer U, Kessler TM. Chronic pelvic pain syndrome: neurostimulation, neuromodulation and acupuncture. Der Urologe. 2012;51:1683-91.

    6. Indexed at, Google Scholar, Cross Ref

Get the App