Back Pain Not Helped with Spinal Cord Stimulation

Back Pain Information

Author: University of Sydney
Published: 2023/03/10 - Peer-Reviewed: Yes
Contents: Summary - Definition - Introduction - Main - Related

Synopsis: Spinal cord stimulation, a medical technology suggested to treat people with chronic back pain, does not provide long-term relief and may cause harm. The researchers analyzed the results of 13 clinical trials, looking at data from 699 participants, comparing spinal cord stimulation treatment with placebo or no treatment for low back pain. The review concluded that spinal cord stimulation is no better than a placebo for treating low back pain, with probably little to no benefit for people with low back pain or improving their quality of life.

Introduction

Spinal Cord Stimulation for Lower Back Pain - Cochrane Database of Systematic Reviews.

Spinal cord stimulation, a medical technology suggested to treat people with chronic back pain, does not provide long-term relief and may cause harm, according to a Cochrane Review.

Main Digest

Spinal cord stimulation is thought to work by implanting a device that sends electrical pulses to the spinal cord to interrupt nerve signals before they reach the brain.

The study reviewed published clinical data on spinal cord stimulation. This included randomized controlled trials, considered the most robust method to measure the effectiveness of a treatment in medical research.

The researchers analyzed the results of 13 clinical trials, looking at data from 699 participants, comparing spinal cord stimulation treatment with placebo or no treatment for low back pain.

Cochrane reviews are trusted by researchers, medical professionals, and policymakers because they use robust methodologies to combine evidence from multiple sources, reducing the impact of bias and random error that can make individual studies less reliable.

The review concluded that spinal cord stimulation is no better than a placebo for treating low back pain, with probably little to no benefit for people with low back pain or improving their quality of life.

There was little to no clinical data regarding the long-term effectiveness of spinal cord stimulation.

Continued below image.
X-ray image of a human spinal column showing spinal cord stimulator implant - Image Credit: McConnell, CC BY 3.0.
X-ray image of a human spinal column showing spinal cord stimulator implant - Image Credit: McConnell, CC BY 3.0.
Continued...

The researchers also found that adverse side effects of the surgery were poorly documented overall, preventing them from concluding the level of risk involved. Harms from spinal cord stimulation could include nerve damage, infection, and the electrical leads moving, all of which may need repeated surgeries.

The review findings have been submitted to the Federal Department of Health and Aged Care prosthesis list review task force. The task force is reviewing the eligibility of current prostheses subsidized by Medicare.

In Australia, the devices' long-term safety and performance are also being re-assessed by The Therapeutic Goods Administration (TGA), the country's regulatory authority for therapeutic goods.

"Spinal cord stimulation is invasive and has a great financial cost to people who choose surgery as a last resort to alleviate their pain. Our review found that the long-term benefits and harms are essentially unknown," said lead researcher Dr. Adrian Traeger from Sydney Musculoskeletal Health, an initiative of the University of Sydney, Sydney Local Health District, and Northern Sydney Local Health District.

"Our review of the clinical data suggests no sustained benefits to the surgery outweigh the costs and risks."

"Low back pain is one of the leading causes of disability worldwide. Our findings further emphasize the need to review funding arrangements for chronic pain care to help patients find relief. There are evidence-based physical and psychological therapies for back pain; ensuring access to these is essential."

The review team found multiple gaps in clinical data.

No studies investigated the long-term (more than 12 months) impact of spinal cord stimulation on low back pain. The longest was a single six-month trial.

Most clinical trials only looked at the immediate impact of the device, which is a time frame of less than a month.

The review team provided recommendations, including that future spinal cord stimulation clinical trials be at least 12 months, clearly document the number of people who experience adverse events, and compare with other pain treatment options.

Professor Chris Maher, Co-Director of Sydney Musculoskeletal Health, said:

"Our review found that the clinical benefit of adding spinal cord stimulation to treat low back pain remains unknown. Coupled with the reality that these devices are costly and often break down, there is a problem here that should concern regulators."

A separate Cochrane review, in which the researchers were not involved, examined the effect of spinal cord stimulation versus placebo in people with chronic pain. Similar to this review, it concluded there was a lack of evidence to suggest long-term benefits in treating chronic pain.

Attribution/Source(s):

This peer reviewed publication was selected for publishing by the editors of Disabled World due to its significant relevance to the disability community. Originally authored by University of Sydney, and published on 2023/03/10, the content may have been edited for style, clarity, or brevity. For further details or clarifications, University of Sydney can be contacted at sydney.edu.au. NOTE: Disabled World does not provide any warranties or endorsements related to this article.

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Cite This Page (APA): University of Sydney. (2023, March 10). Back Pain Not Helped with Spinal Cord Stimulation. Disabled World. Retrieved July 23, 2024 from www.disabled-world.com/disability/types/spinal/backpain/spinal-cord-stimulation.php

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