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NICE approves spinal cord stimulation for chronic neuropathic pain

People living a life of constant pain will now have access to spinal cord stimulation (SCS) following new guidance issued by the National Institute for Health and Clinical Excellence (NICE).

The guidance recommends that SCS should be made available to all patients who continue to experience chronic neuropathic pain for at least six months despite trying conventional approaches to pain management. Patients will also be required to have had a successful trial of the therapy before a spinal cord stimulator is implanted.

The guidance is good news for patients with chronic neuropathic pain conditions like complex regional pain syndrome, a burning pain in one or more limbs. However, NICE has not recommended SCS for people with ischaemic pain ruling out the treatment for people experiencing chronic pain caused by conditions such as refractory angina.
Complex regional pain syndrome is estimated to occur after one in every 2,000 accidents. One in five people suffer from chronic pain, which affects people of any age and can lead to sleep disturbance and frequent absence from work.

Dr Sam Eldabe from the James Cook University Hospital, Middlesbrough, commented, "Spinal cord stimulation is an important treatment option for people living with neuropathic pain who face considerable pain on a daily basis and who have already tried numerous pharmacological approaches to pain management without success.

"These new guidelines, properly implemented at a local level, will provide access to a therapy which can significantly reduce the pain experienced by many people and lead to a dramatic improvement in their quality of life."

Ian Semmons, Chairman of Action on Pain, commented, "This represents a sensible move by NICE for not only does it provide a valuable asset for people affected by pain, it also gives NICE the opportunity to revisit their decision in the future, with the potential to extend the usage of spinal cord stimulators to encompass other pain-related conditions."


Do you think these guidelines are an important step in the treatment of chronic pain? Your comments: (Terms and conditions apply)

"Yes, indeed, I do ..." - Karen Wiesner, CA, USA

"I think your decision is great. I acquired CRPS after an accident with a manhole on 12 February 2006 and was bedridden in nine months. In August 2007 my first permanent SCS was placed. I say first because my lead popped out and I had to have a revision done. January 2008 was my second SCS. I feel as though I am a success story. I have down days still. However, I am in less pain than I was before, and I take less medications than I did before. I was taking about 17-20 pills a day which included different narcotics and various nerve medications. I can honestly say that I take max 5-7 pills a day now, depending on my activity level during the day.
I would recommend with the SCS implant that people get extensive psychological help in dealing with the depression and sadness that come with having chronic pain. Make the two go hand in hand. I could not get to where I am now until I got stronger mentally. I decreased, and then ended, most of my medications by May 2008, after I became mentally stronger.
You made a great decision to use stimulation and conclude it to be a cost-effective use of NHS resources." - Christine, CA, USA