Direct Sciatic Nerve Electrical Stimulation for Complex Regional Pain Syndrome Type 1

Buwembo, Joseph; Munson, Russell; Rizvi, Syed; Ijaz, Aadam; Gupta, Shivani

doi:10.1111/ner.13294

Cited by 12 publications

(4 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“… 93 Buwembo et al reported a case of direct sciatic nerve stimulation reducing intractable pain from CRPS by 59% along with cessation of autonomic features such as color changes, swelling, and sensory dysfunction. 94 …”

Section: Summary Of Literaturementioning

confidence: 99%

Evidence-Based Clinical Guidelines from the American Society of Pain and Neuroscience for the Use of Implantable Peripheral Nerve Stimulation in the Treatment of Chronic Pain

Strand¹,

D’Souza²,

Hagedorn³

et al. 2022

JPR

View full text Add to dashboard Cite

The objective of this peripheral nerve stimulation consensus guideline is to add to the current family of consensus practice guidelines and incorporate a systematic review process. The published literature was searched from relevant electronic databases, including PubMed, Scopus, Cochrane Central Register of Controlled Trials, and Web of Science from database inception to March 29, 2021. Inclusion criteria encompassed studies that described peripheral nerve stimulation in patients in terms of clinical outcomes for various pain conditions, physiological mechanism of action, surgical technique, technique of placement, and adverse events. Twenty randomized controlled trials and 33 prospective observational studies were included in the systematic review process. There is Level I evidence supporting the efficacy of PNS for treatment of chronic migraine headaches via occipital nerve stimulation; chronic hemiplegic shoulder pain via stimulation of nerves innervating the trapezius, supraspinatus, and deltoid muscles; failed back surgery syndrome via subcutaneous peripheral field stimulation; and lower extremity neuropathic and lower extremity post-amputation pain. Evidence from current Level I studies combined with newer technologies facilitating less invasive and easier electrode placement make peripheral nerve stimulation an attractive alternative for managing patients with complex pain disorders. Peripheral nerve stimulation should be used judiciously as an adjunct for chronic and acute postoperative pain following adequate patient screening and positive diagnostic nerve block or stimulation trial.

show abstract

Section: Summary Of Literaturementioning

confidence: 99%

Evidence-Based Clinical Guidelines from the American Society of Pain and Neuroscience for the Use of Implantable Peripheral Nerve Stimulation in the Treatment of Chronic Pain

Strand¹,

D’Souza²,

Hagedorn³

et al. 2022

JPR

View full text Add to dashboard Cite

show abstract

“…Tu et al proposed that, following PNS on sacral nerves, afferent signals were transmitted to the brainstem and that the efferent anti-inflammatory output is transmitted by the vagus nerve [ 40 ] . Despite recent reports of the use of SNS to treat chronic pain [ 41 ], whether SNS affects inflammation remains unclear. Notably, it has been reported that 60–100 Hz stimulation resulted in paresthesia of the innervated region and produced analgesic effects via the gate-control mechanism [ 42 , 43 ].…”

Section: Discussionmentioning

confidence: 99%

Sciatic nerve stimulation alleviates acute neuropathic pain via modulation of neuroinflammation and descending pain inhibition in a rodent model

Wong

Lee

et al. 2022

J Neuroinflammation

View full text Add to dashboard Cite

Background Neuropathic pain (NP) is characterized by abnormal activation of pain conducting pathways and manifests as mechanical allodynia and thermal hypersensitivity. Peripheral nerve stimulation is used for treatment of medically refractory chronic NP and has been shown to reduce neuroinflammation. However, whether sciatic nerve stimulation (SNS) is of therapeutic benefit to NP remains unclear. Moreover, the optimal frequency for SNS is unknown. To address this research gap, we investigated the effect of SNS in an acute NP rodent model. Methods Rats with right L5 nerve root ligation (NRL) or Sham surgery were used. Ipsilateral SNS was performed at 2 Hz, 20 Hz, and 60 Hz frequencies. Behavioral tests were performed to assess pain and thermal hypersensitivity before and after NRL and SNS. Expression of inflammatory proteins in the L5 spinal cord and the immunohistochemical alterations of spinal cord astrocytes and microglia were examined on post-injury day 7 (PID7) following NRL and SNS. The involvement of the descending pain modulatory pathway was also investigated. Results Following NRL, the rats showed a decreased pain threshold and latency on the von Frey and Hargreaves tests. The immunofluorescence results indicated hyperactivation of superficial spinal cord dorsal horn (SCDH) neurons. Both 2-Hz and 20-Hz SNS alleviated pain behavior and hyperactivation of SCDH neurons. On PID7, NRL resulted in elevated expression of spinal cord inflammatory proteins including NF-κB, TNF-α, IL-1β, and IL-6, which was mitigated by 2-Hz and 20-Hz SNS. Furthermore, 2-Hz and 20-Hz SNS suppressed the activation of spinal cord astrocytes and microglia following NRL on PID7. Activity of the descending serotoninergic pain modulation pathway showed an increase early on PID1 following 2-Hz and 20-Hz SNS. Conclusions Our results support that both 2-Hz and 20-Hz SNS can alleviate NP behaviors and hyperactivation of pain conducting pathways. We showed that SNS regulates neuroinflammation and reduces inflammatory protein expression, astrocytic gliosis, and microglia activation. During the early post-injury period, SNS also facilitates the descending pain modulatory pathway. Taken together, these findings support the therapeutic potential of SNS for acute NP.

show abstract

“…PNS may alleviate pain by disrupting the nociceptive afferent fibers, downregulating inflammatory mediators, and changing the local microenvironment [81][82][83]. One prospective study and three retrospective studies comprising 207 patients were identified [67][68][69][70]. These studies showed that PNS reduced pain and opioid consumption.…”

Section: Interventional Treatmentsmentioning

confidence: 99%

Complex Regional Pain Syndrome: Updates and Current Evidence

Her,

Kubrova,

Dombovy-Johnson

et al. 2024

Curr Phys Med Rehabil Rep

View full text Add to dashboard Cite

Purpose of Review Complex regional pain syndrome (CRPS) is a debilitating condition that manifests with sensory, neurologic, autonomic, and/or trophic impairment. In addition to manifesting with severe neuropathic pain, CRPS is associated with poor quality of life and higher annual healthcare costs. This systematic review appraises the current body of evidence on all treatment modalities for CRPS. Recent Findings In patients with CRPS-related pain, there is level I evidence supporting modest to moderate improvement in pain intensity from physical therapy, occupational therapy, massage therapy, acupuncture, and transcutaneous electrical nerve stimulation (TENS), although changes in functionality were inconsistent. Topical medications such as eutectic mixture of local anesthetic (EMLA) and ketamine cream were associated with decreased allodynia and hyperalgesia. Inconsistency was present in the current literature in terms of the analgesic effects of gabapentinoids for CRPS. Patients who received intramuscular or intravenous bisphosphonate therapy may achieve modest to moderate improvement in pain intensity and functionality. Systemic steroid and ketamine provided only short-term pain reduction. In terms of interventional therapy, there was an association of modest to moderate improvement in pain with sympathetic ganglion block, sympathectomy, dorsal column spinal cord stimulation, dorsal root ganglion stimulation, and peripheral nerve stimulation, although the level of evidence was limited. Summary In summary, the purpose of this systematic review is to equip the clinician with important updates on conservative, pharmacologic, and interventional treatment modalities for CRPS-related pain.

show abstract

Direct Sciatic Nerve Electrical Stimulation for Complex Regional Pain Syndrome Type 1

Cited by 12 publications

References 29 publications

Evidence-Based Clinical Guidelines from the American Society of Pain and Neuroscience for the Use of Implantable Peripheral Nerve Stimulation in the Treatment of Chronic Pain

Evidence-Based Clinical Guidelines from the American Society of Pain and Neuroscience for the Use of Implantable Peripheral Nerve Stimulation in the Treatment of Chronic Pain

Sciatic nerve stimulation alleviates acute neuropathic pain via modulation of neuroinflammation and descending pain inhibition in a rodent model

Complex Regional Pain Syndrome: Updates and Current Evidence

Contact Info

Product

Resources

About