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- W2003286183 abstract "1.Recognize current pathophysiology of neuropathic pain.2.Discuss results of new clinical trials with neurocutaneous and spinal cord electrical stimulation. Purpose. Neuropathic pain (NP) is common in cancer and non-cancer patients and pain management is often unsatisfactory. An evolving hypothesis for reducing NP involves direct nerve stimulation. The hypothesized mechanisms include raising the “gate” threshold at the spinal cord, reducing “wind up” (central sensitization of the spinal cord and brain), reducing impulses from the damaged nerve, and remodeling. Methods. We will review the evidence for the causation of NP, in particular chemotherapy-induced PN (CIPN) and relief by invasive and non-invasive methods. Results. Spinal cord stimulation has been successful in small non-randomized series for chronic pain from complex regional pain syndromes and post-herpetic neuropathy. Acupuncture has been useful but randomized trials are ongoing. We evaluated the MC5-A Calmare® therapy device, a patient-specific cutaneous electro-stimulation given for 1-hour interventions daily. In refractory CIPN, 15 of 16 patients had relief and the pain score fell from 5.81±1.11 to 2.38±1.82 (-59% <0.0001) (Smith et al., in press). In a trial for 52 patients with spinal cord stenosis, PHN, or postsurgical pain randomized to guideline-based pharmacological treatment or MC5-A therapy, the mean visual analogue scale score was reduced from 8.1 to 5.8 (-28%) in the control group and from 8 to 0.7 points (-91%) in the MC5-A group (P < 0.0001) sustained at 2 and 3 months (Marineo et al.,under review). No adverse effects were observed in either trial. MC5-A Scrambler therapy relieved chronic NP quickly and durably. Further studies are underway. Conclusions. There are exciting, new ways to relieve pain that include direct spinal cord stimulation, neurocutaneous stimulation, high intensity, light therapy, and spinal fluid infusions. We will review the available evidence weighing benefits, risks, and costs. Physical Aspects of Care" @default.
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- W2003286183 date "2011-01-01" @default.
- W2003286183 modified "2023-09-28" @default.
- W2003286183 title "Living Better Electronically: Relief of Pain with Neurocutaneous and Spinal Cord Stimulation (513) (Advanced)" @default.
- W2003286183 doi "https://doi.org/10.1016/j.jpainsymman.2010.10.162" @default.
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