The Role of Spinal Cord Stimulation in Axial Back Pain

Chronic axial low back pain (LBP) is one of the most common ailments in the United States, with a significant impact on quality of life and function. Multimodal therapy is often utilized for pain relief, including opioid pain medication. Current indications for spinal cord stimulation include chronic neuropathic conditions, such as failed back surgery syndrome, radiculopathies, complex regional pain syndrome types I and II, postherpetic neuralgia, and peripheral diabetic neuropathies. While current lead placements perform remarkably when used for their appropriate indications, there is no specific indication for spinal cord stimulation in the treatment of axial LBP. However, spinal cord stimulation lead placement at then mid-vertebral body can be considered in patients with significant or predominant complaints of axial LBP. Achievement of pain relief via spinal cord stimulation can reduce the administration of both opioid and non-opioid pain medications.