NICE approves spinal cord stimulation
27 Oct 2008
Spinal cord stimulation recommended as a treatment for chronic neuropathic pain.
The National Institute for Health and Clinical Excellence (NICE) published new guidance (in October 2008) on the use of spinal cord stimulation.
Spinal cord stimulation is a method that can be used to relieve pain. A small device that produces mild electrical pulses is placed inside the body by an operation. These pulses are sent to the spinal cord, causing a ‘stimulation’ effect, which changes the way a person feels pain. The feeling of pain is masked with a tingling sensation in the area of the body that normally hurts.
The new guidance states:
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Spinal cord stimulation is recommended as a possible treatment for adults with chronic pain of neuropathic origin if they:
(a) continue to experience chronic pain (measuring at least 50 mm on a 0–100 mm visual analogue scale) for at least six months despite standard treatments, and
(b) have had a successful trial of spinal cord stimulation as part of an assessment by a specialist team -
Treatment with spinal cord stimulation should only be given after the person has been assessed by a specialist team experienced in assessing and managing people receiving treatment with spinal cord stimulation.
The new guidance from NICE only applies to adults with chronic neuropathic pain. Chronic refers to pain that has continued for more than several months, or for longer than is expected (for example, after an illness or injury). Neuropathic pain is caused by problems with the body’s nerves – this can be because the nervous system is not working properly or because the nerves themselves have been damaged. The cause of neuropathic pain is often hard to identify, and more than one part of the body can hurt at the same time.
In some people with long-term back pain, the pain may be of neuropathic origin. It is for this group that spinal cord stimulation may be suitable. However, the guidance clearly states that other options should be explored first. Spinal cord stimulation requires surgery and people considering spinal cord stimulation should carefully weigh the benefits with the risks and costs. This is where the specialist team is essential.
BackCare is pleased to have the option of spinal cord stimulation now added to the treatment options for people with chronic neuropathic pain.
More information on the new NICE guidance can be found on http://www.nice.org.uk/guidance/index.jsp?action=byID&o=12082 or download the patient version of the NICE document on http://www.nice.org.uk/Guidance/TA159/PublicInfo/pdf/English