Practice Parameters for the Use of Spinal Cord Stimulation in the Treatment of Chronic Neuropathic Pain

SCS for chronic neuropathic pain

NOTE: Since we built this website, many innovations have occurred in the use of spinal cord stimulation, including new equipment, waveforms, and treatment strategies. We are in the process of updating this site to incorporate information about these advances.

To optimize the use of spinal cord stimulation as a treatment for chronic neuropathic pain, this website provides a synthesized, critical, and clear compilation of answers to more than 60 key clinical questions that cover the indications and potential beneficial outcomes of SCS as a treatment of chronic neuropathic pain and the clinical decisions involved in the use of SCS in the target patient population.

In addition, treatment practices are graded from “options” to “recommended” in the first system that incorporates, among other evidence sources, an assessment of the likelihood of a favorable outcome based on the evidence provided by expert consensus combined with a consideration of potential risk/benefit.

Although the information in this document might influence or reinforce physician choices, it is not intended to be coercive or judgmental, and it should not be considered as medical advice.  The evidence that supports the clinical decisions and treatment options is presented and graded with the sole objective of informing clinicians who wish to incorporate this information into their practices. In addition, the information provided has important implications for the cost and consumption of health care resources; these implications will be appropriately noted.

Most references are cited multiple times (in each pertinent category). Thus, this is the first evaluation that seeks to categorize and place the entire SCS clinical literature at the disposal of the reader.

These practice parameters will apply to the majority of patients; in each case, however, the answers to the clinical practice questions are useful for individualizing treatment and are not meant as a substitute for a clinician's best judgment.

Last updated in 2008.  A major update is planned during 2019.