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High-Frequency Spinal Cord Stimulation | New Promising Treatment for Neuropathic Pain

According to a new study, a new treatment for chronic peripheral polyneuropathy is on the horizon. Although spinal cord stimulation (SCS) has been effective therapeutic treatment for over 50 years to treat neuropathic pain, using high-frequency spinal cord stimulation, at 10 kHz, has the ability to treat patients who have thus far been unable to find relief from their chronic pain.  

Neuropathic pain is generated by nerve tissue, and is responsible for 30 to 65% of activity seen at pain management clinics. Spinal cord stimulation offers a clinical and cost-effective treatment at lower lifetime healthcare cost with better long-term outcomes in such patients.  The most popular treatment in the family of therapies called neuromodulation, SCS continues to evolve. Until 10 kHz technology, it was thought that one needs nerve action potentials to achieve pain reduction, meaning the action potentials reach sensory nerve perceptions and the patient feels the stimulation. When high frequency levels are used, the patient is unaware of the stimulation.

Dr. Peter Staats and Dr. Sean Li of Premier Pain Centers in New Jersey conducted this study where they implanted two epidural leads that spanned C2­-C6 vertebrae for those with upper limb pain and T8-­T11 vertebrae for lower limb pain, in a total of 26 patients with minor stenosis, epidural scarring, or myelopathy.

“While it is a preliminary study, the study found that we can control (pain in patients) who were previously not amenable to stimulation,” Dr. Staats informed Reuters Health.

Out of the 26 patients, 22 patients reported 40% or greater pain relief and were eligible for permanent implants, and while 3 declined and 1 was removed, 18 patients were left to study.  After one month, pain had improved from 7.5 cm to 2.1 cm on a visual pain scale from 0 to 10. The response rate after one month was 81.3%, or 13 of the 16 patients who made it to follow-­up.

Dr. Poree, a pain specialist from the University of California who was not involved in this study told Reuters Health, “These results are consistent with earlier findings reported with low-­frequency spinal cord stimulation and further highlight the value of employing spinal cord stimulation in the treatment of a wide spectrum of neuropathic pain conditions.”

Dr. Staats calls this data, “quite strong,” and believes this research, if randomized and controlled, could provide a revolutionary new treatment strategy for patients with both idiopathic peripheral neuropathy and even diabetic neuropathy.  

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