The effectiveness of spinal cord stimulation combined with conventional therapy in reducing chronic pain

Abstract

Overview of the topic: Chronic pain is a complex health condition which usually persists for more than six months. Nowadays, chronic pain is being considered as a disease rather than just a symptom. Chronic pain is the main cause of disability, both in the developed and in the developing countries, and a significant contributor to health costs. The use of spinal cord stimulation helps individuals to manage better their pain, and also decrease the opioid consumption. In addition, spinal cord stimulation may be an alternative option for those individuals who cannot control their pain with other forms of therapies. The research question: Does spinal cord stimulations (SCS) combined with other conventional therapy reduce chronic pain, compared to conventional therapy alone? PICO elements: Population: Patients with chronic pain, Intervention: Spinal cord stimulation with conventional therapy, Comparison: Conventional therapy alone, Outcome: Pain reduction

Method: The PICO elements were used as key components to create alternative words, which were then combined by using the Boolean Operators. Limiters were also used to narrow down the search results. The combined words were searched in; EBSCO and PubMed. In addition, Google Scholar was also searched. The PRISMA 2009 checklist was adapted to eliminate all the irrelevant articles.

Results: A total of six (6) articles were identified, which included one (1) systematic review and five (5) randomized control trials. Scientific evidence supports that the use of spinal cord stimulation in addition to conventional therapy can have a better outcome than conventional therapy alone, in pain reduction. Only one trial, which was included in the systematic review failed to achieve positive outcomes with spinal cord stimulation. With regards to cost-effectiveness, the results were not significant amongst the key studies. Conclusion: An established result cannot be presented however it seems that there is evidence hinting the likelihood of benefits when using spinal cord stimulation. However more research is needed in the area to answer the PICO question of this project.

Implication and Recommendations: Recommendation from this dissertation include addressing and bridging the gaps in literature, the necessity to address the promising benefits of spinal cord stimulations when educating the general public, students and also healthcare professional about spinal cord stimulator and carrying out a pilot study to examine the practicality for a local larger study and policy making, regarding the best treatment choices for chronic pain. The need to conduct local research, since no studies were found regarding the Maltese population.