“On the Shoulders of Giants”: A History of the Understandings of Pain, Leading to the Understandings of Neuromodulation

Keller, Thomas; Krames, Elliot S.

doi:10.1111/j.1525-1403.2009.00196.x

Cited by 12 publications

(5 citation statements)

References 27 publications

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“…Gate control theory as proposed by Melzack and Wall may explain how activation of large myelinated nerve fibers by PNS can inhibit transmission of pain signals from the spinal cord to higher centers in the central nervous system to decrease the perception of pain . The inhibition of nociceptive activity in central pain pathways such as the spinothalamic tract is the most commonly cited mechanism of PNS‐induced pain relief .…”

Section: Discussionmentioning

confidence: 99%

Treatment of Post-Amputation Pain With Peripheral Nerve Stimulation

Rauck

Cohen

Gilmore

et al. 2014

Neuromodulation: Technology at the Neural Interface

116

141

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Section: Discussionmentioning

confidence: 99%

Treatment of Post-Amputation Pain With Peripheral Nerve Stimulation

Rauck

Cohen

Gilmore

et al. 2014

Neuromodulation: Technology at the Neural Interface

116

141

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“…Gate control theory as proposed by Melzack and Wall may explain how activation of large myelinated nerve fibers by PNS can inhibit transmission of pain signals (and “close the gate”) from the spinal cord to higher centers in the central nervous system to decrease the perception of pain 45–47 . Although other theories exist, gate theory is the most common explanation of the mechanism through which PNS achieves pain relief by inhibiting activity in central pain pathways, such as the spinothalamic tract 22,47–49 …”

Section: Discussionmentioning

confidence: 99%

Peripheral Nerve Stimulation for the Treatment of Postamputation Pain—A Case Report

et al. 2012

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Many amputees suffer from post-amputation pain, which can be extremely debilitating, decrease quality of life, increase the risk of depression, and negatively affect interpersonal relationships and the ability to work. Present methods of treatment, including medications, are often unsatisfactory in reducing post-amputation pain. Electrical stimulation of the nerve innervating the painful area could reduce the pain, but peripheral nerve stimulation is rarely used to treat post-amputation pain because present methods require invasive surgical access and precise placement of the leads in close proximity (≤ 2 mm) with the nerve. The present study investigated a novel approach to peripheral nerve stimulation in which a lead was placed percutaneously a remote distance (> 1 cm) away from the femoral nerve in a patient with severe residual limb pain 33 years following a below-knee amputation. Electrical stimulation generated ≥ 75% paresthesia coverage, reduced residual limb pain by > 60%, and improved quality of life outcomes as measured by the pain interference scale of the Brief Pain Inventory-Short Form (100% reduction in pain interference), Pain Disability Index (74% reduction in disability), and the Patient Global Impression of Change (Very Much Improved) during a 2-week home trial. There were no adverse events. The ability to generate significant paresthesia coverage and pain relief with a single lead inserted percutaneously and remotely from the target nerve holds promise for providing relief of post-amputation pain.

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“…Neuromodulation generally involves the selective application of a programmable pulse waveform through a series of electrodes within a lead to stimulate afferent nerve fibers and, subsequently, reduce the perception of pain [1]. This treatment is most indicated in cases of severe localized pain, intractable to analgesics, and other conventional therapies.…”

Section: Introductionmentioning

confidence: 99%

“…This treatment is most indicated in cases of severe localized pain, intractable to analgesics, and other conventional therapies. The use of electrical stimulation for the treatment of pain dates back to the late 1800s when Julius Althaus applied alternating current electrotherapy to peripheral nerves for pain relief [1]. However, it was not until the publications by Melzack and Wall [2] and Shealy and colleagues [3] did neuromodulation in the form of spinal cord stimulation (SCS) become a noted alternative to traditional pain management.…”

Section: Introductionmentioning

confidence: 99%