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

Pain Characteristics

What are the characteristics of the pain that is most likely to be treated successfully by SCS?

  • The pain is radicular or radiating rather than axial in distribution (predominant low back pain is more difficult to treat).
  • The pain is neuropathic rather than nociceptive in nature.
  • The pain has an objective basis and a distribution consistent with the results of the physical examination and diagnostic, e.g., imaging, studies.
  • The painful condition is linked to a specific diagnosis.
  • Objective findings predominate (as opposed to functional, nonphysiologic signs).
  • The pain is adequately relieved during an SCS screening trial.
  • Some investigators report that the success of SCS decreases as the length of time since the onset of pain increases.

Strength of recommendation Evidence sources/rationale
B = Recommended
Uncertain validity, apparently useful

  • Weighing risk versus potential benefit and expert consensus reveals a good likelihood of a favorable outcome

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Abstract

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