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Painful Neuropathy and clinically effective evidence supported treatments

One of the most difficult conditions to treat, the burning, shooting agonizing chronic neuropathic pain, brings suffering patients to our Interventional Pain practice seeking diagnostic and treatment answers.

Not all neuropathic chronic pain is the same. Different etiologies include: Painful Diabetic Peripheral Neuropathy, Ischemic Neuropathy, Idiopathic Peripheral Neuropathies, Spine related Radiculopathies, and Complex Regional Pain Syndromes (CRPS I-RSD/ CRPS II-Causalgia) of the upper and lower extremities.

Conservative as well as pharmacological treatment options are usually ineffective. Most of these patients will go on for years receiving high doses of medications like gabapentin or pregabalin with all the associated significant side effects. Additionally, a very large number of these patients will go on being prescribed controlled substances such as high doses of narcotics with the detrimental  dependence and addiction that follows.

Most patients and physicians alike are to this day agnostic of the available and highly successful interventional pain management options for this type of intractable chronic neuropathic pain conditions. For the chronic painfull peripheral neuropathies  early recognition and implementation of interventional Pain management treatments can reverse the course of the disease and together with aggressive physical therapy provide effective treatment. For chronic conditions including intractable CRPS, chronic intractable painful diabetic neuropathy of the extremities, as well as chronic painful peripheral neuropathies of any other etiology (ischemic, metabolic, etc.) the one therapy that has been validated by research as well as clinical practice as effective and safe  is spinal cord stimulation.

Spinal cord stimulation is an available therapy that has been around for more than three decades and has evolved to be one of the most successful treatments available to date for these types of conditions.

Spinal Cord Stimulationn is FDA approved for painfull Diabetic Neuropathy (PDN).

Spinal cord stimulation (SCS) is considered an effective, safe, well-tolerated, and reversible treatment option and studies have demonstrated significant pain relief and improved functioning in patients with Painful Diabetic Neuropathy (PDN) and peripheral Neuropathy who did not find adequate relief with standard treatments.

Multiple studies and clinical trials have validated the efficacy of spinal cord stimulation (SCS) for painful diabetic neuropathy. Relevant research includes "Spinal cord stimulation and pain relief in painful diabetic peripheral neuropathy: a prospective two-center randomized controlled trial" which supports the effectiveness of SCS in providing pain relief for this condition (pubmed.ncbi.nlm.nih.gov/25216508). Another study, "Effect of High-frequency (10-kHz) Spinal Cord Stimulation in Patients With Painful Diabetic Neuropathy," also demonstrates the potential benefits of SCS for this specific type of neuropathic pain (jamanetwork.com/journals/jamaneurology/fullarticle/2777806). Additionally, the article "Spinal Cord Stimulation and Pain Relief in Painful Diabetic Neuropathy" showcases the findings of a prospective multicenter study assessing the effectiveness of SCS in addressing painful diabetic neuropathy (diabetesjournals.org/care/article/37/11/3016/29087/Spinal-Cord-Stimulation-and-Pain-Relief-in-Painful). These sources illustrate the scientific support for SCS as a viable treatment for painful diabetic neuropathy.

 

Expert Pain is the practice of Doctor Ioannis Skaribas MD, FASA, Fellow of the American Society of Anesthesiologists.
Doctor Skaribas is an Interventional Anesthesiologist double board certified in Anesthesiology and Pain Medicine, and fellowship trained and Interventional Pain Management at Baylor College of Medicine in Houston TX. 
Dr. Skaribas has more than 20 years’ experience in Spinal Cord Stimulation and Interventional Pain Medicine. He is a key opinion leader in Spinal Cord Stimulation and Neuromodulation both nationally and internationally with. Multiple publications in the field. 

For more information, visit expertpaincare.com or call us at 832-862-7246.

https://www.expertpaincare.com/

 
Bibliography
 
1. Torrance N., Smith B.H., Bennett M.I., Lee A.J. The epidemiology of chronic pain of predominantly neuropathic origin. Results from a general population survey. J. Pain. 2006;7:281–289. doi: 10.1016/j.jpain.2005.11.008. 
2. Finnerup N.B., Otto M., McQuay H.J., Jensen T.S., Sindrup S.H. Algorithm for neuropathic pain treatment: an evidence based proposal. Pain. 2005;118:289–305. doi: 10.1016/j.pain.2005.08.013. 
3. Lee A.W., Pilitsis J.G. Spinal cord stimulation: Indications and outcomes. Neurosurg. Focus. 2006;21:1–6. doi: 10.3171/foc.2006.21.6.6. 
4. Melzack R., Wall P.D. Pain mechanisms: A new theory. Science. 1965;150:971–979. doi: 10.1126/science.150.3699.971. 
5. Deer T., Skaribas I. Effectiveness of Cervical Spinal Cord Stimulation for the Management of Chronic Pain.Neuromodulation: Technology at the Neural InterfaceVolume 17, Issue 3, April 2014, Pages 265-27.

 

 

 

Author
Ioannis Skaribas MD FASA DABA Double board-certified Anesthesiologist and Interventional Pain Management Specialist Ioannis Skaribas, MD, DABA, FASA, is a highly gifted and experienced physician renowned for his expertise in Spinal Cord Neurostimulation and advanced interventions.

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