Bioelectronics provides options in treatment of chronic pain
Bioelectrical medicine gives practitioners a fresh outlook on the treatment of chronic pain, finds a study that reviewed stimulation of the spinal cord, dorsal root ganglion and peripheral nerves
Bioelectrical medicine gives practitioners a fresh outlook on the treatment of chronic pain
Chronic pain is notoriously resistant to conventional medical management. This has led to an overuse of prescription opioid analgesics linked to an increasing number of deaths.
Doctors are seeking an alternative approach, and some see an answer in neuromodulation, a process of inhibition, stimulation or therapeutic alteration of activity in the nervous system with the use of electricity.
A study reviewing stimulation of the spinal cord, dorsal root ganglion and peripheral nerves has found this approach could be developed to give practitioners a fresh outlook regarding the treatment of chronic pain.
Good results and shortcomings
Spinal cord stimulation has been used for several decades. It has shown good results but has shortcomings, including paraesthesia – a sensation of burning, prickling, itching or numbness. There is also a possibility of developing tolerance, which makes treatment less effective over time.
New types of neuromodulation that have been developed include burst spinal cord stimulation, which delivers pulses of electricity that mimic the natural firing pattern of neurones. These pulses have proved to be superior to conventional treatment in reducing lower back pain.
Another development is high-frequency stimulation therapy, which is thought to act by interfering with the normal rhythm of the neuronal signals that transmit pain.
These two therapies provide better pain management and also an option for paraesthesia-free stimulation, which may be preferred by some patients. Given the shortage of viable treatment options for intractable pain, neuromodulation presents exciting possibilities for new treatments.
‘These are times of advancement in the field of bioelectrical medicine,’ the study’s authors say. But with this progress come responsibilities that include a commitment to improve efficacy, mitigate complications and find innovations, along with a commitment to ethics and patient safety, they add.
- Deer T, Jain S, Hunter C et al (2019) Neurostimulation for intractable chronic pain. Brain Sciences. 9, 2, pii:E23. doi: 10.3390/brainsci9020023
Ruth Sander is an independent consultant in the care of older people