Pain relief and opioid usage in upper limb and neck pain patients after 10-kHz spinal cord stimulation treatment: subanalysis of USA studies

Aim: It is argued that chronic pain patients who reduce/eliminate their opioids may have compromised pain relief. This study therefore aimed to analyze if reduced opioid consumption associated with 10-kHz spinal cord stimulation adversely affected pain relief. Methods: Post hoc analysis was performed on data from two prospective studies in subjects with upper limbs and neck pain conducted in USA. Results & conclusion: A 10-kHz spinal cord stimulation treatment was associated with reduction in mean visual analog scale scores for upper limbs and neck pain and mean daily opioid consumption. Pain scores decreased in subjects who decreased opioid use and in those who maintained/increased use. Opioid reduction and pain relief was also achieved in subjects taking >90 mg morphine equivalents of opioids at baseline. Lay abstract Weaning off opioids or reducing the dose in patients with chronic pain is believed to increase the pain intensity. The guidance issued by Health and Human Services in 2019 highlighted the need to balance risks and benefits during tapering, and the importance of incorporating opioid-sparing treatments for chronic pain. 10-kHz spinal cord stimulation (SCS) has been previously shown to provide durable pain relief and help in reducing dependence on opioids for pain management. Current study further showed that 10-kHz SCS treatment helped patients with chronic upper limb and neck pain in reducing opioid dependence. More importantly, current study demonstrated that there was no rebound increase in 10-kHz SCS treated patients who reduced/eliminated opioid use.