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Spinal Cord Stimulation for Post-Shingles Pain

January 09, 2018

Recent Study Using Spinal Cord Stimulation to Treat Post Herpetic Neuralgia

China Medical University’s Department of Pain Medicine recently published a study entitled ‘Efficacy of Short-Term Spinal Cord Stimulation in Acute/Sub-acute Zoster-Related Pain’ in July 2017. They put this insightful publication together after several months of continuous series of tests to evaluate the effectiveness of short-term spinal cord stimulation in patients with refractory acute/sub-acute zoster-related pain. This study demonstrates the potential of neuromodulation with spinal cord stimulation to achieve relief in refractory acute or subacute pain related to postherpetic neuralgia. It is quite possible that in the future spinal cord stimulation may be a common solution for this very painful condition.

Often, the pain of acute/sub-acute zoster can escalate to a condition known as ‘Postherpetic Neuralgia (PHN).’ This is a refractory condition that impairs the patient’s quality of life may develop following a case of herpes zoster, also known as shingles.

Over the years, doctors have tried many ways to prevent acute and sub-acute herpes zoster-related pain from turning into postherpetic neuralgia, with limited or variable success. Although many studies have been conducted over time, few looked at spinal cord stimulation as a viable remedy for this condition until recently when spinal cord stimulation showed promising results.

In the spinal cord stimulation study, a total of 46 patients with herpes zoster-related pain that had previously undergone the usual therapies without much success underwent short-term spinal cord stimulation. Visual Analogue Scale (VAS), analgesic consumptions among other outcome variables were recorded before and after the stimulation.  69.6% of the test subjects achieved significant improvement in their pain. 39.1% of the patients in the study achieved complete relief of their pain with a VAS score of <2/10. In these test subjects, the duration of the postherpetic neuralgia did not make a significant difference in the amount of relief achieved. Additionally, there were no severe complications reported in the follow-up period. The study did not compare spinal cord stimulator therapy to conventional therapy and did not assess the relief achievable on those patients with only mild to moderate pain.

References;
1. Dong, Dao-Song, Xue Yu, Cheng-Fu Wan, Yan Liu, Lin Zhao, Qi Xi, Wen-Yao Cui, Qiu-Shi Wang, and Tao Song. "Efficacy of Short-Term Spinal Cord Stimulation in Acute/Subacute Zoster-Related Pain: A Retrospective Study." Pain physician 20, no. 5 (2017): E633-E645.

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