Spinal cord stimulation (SCS) for chronic pain was first described in 1967 by Dr. Shealy. It consists of applying electrical current to the posterior aspect of the spinal cord in an attempt to decrease the pain signals traveling to and from the brain. Since Dr. Shealy introduced this concept, medicine has sought to improve SCS results through innovative technology. While traditional SCS (TSCS) relies on creating a paresthesia or tingling sensation at the area of pain, recent advancements have allowed patients to live paresthesia-free and potentially experience improved pain control. This article will focus on one iteration of this new wave of technology, described as high frequency SCS (HFSCS).
This form of stimulation has been approved for use in Australia and Europe since 2011 and the United States since 2015. It involves the use of a low energy impulse that the body cannot sense. Therefore, the pain signals are blocked and the patient doesn’t experience the tingling sensation commonly associated with TSCS. This is important because most patients prefer a SCS system that avoids paresthesia creation.
Looking at the research involving SCS, TSCS has been proven to be effective through multiple randomized controlled trials for pain control in complex regional pain syndrome (CRPS), failed back surgery syndrome (FBSS), and painful peripheral neuropathy. While TSCS has proven beneficial for FBSS, HFSCS may provide even greater improvements for this patient population. In 2015 and 2016, two large studies were published that showed HFSCS provided superior results for FBSS with leg pain compared to TSCS. In addition, the medical community continues to work hard to expand indications for HFSCS. Current studies include nonsurgical low back pain, painful diabetic neuropathy, neck and upper extremity pain, and abdominal pain. I am hopeful that in the coming years we may have strong evidence for many other painful conditions.
To learn more about TSCS or HFSCS and how it may be beneficial for you, please contact our division for a consultation with one of our pain medicine physicians.
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