Percutaneous Peripheral Nerve Stimulation for the Treatment of Chronic Low Back Pain: Two Clinical Case Reports of Sustained Pain Relief

Leonardo Kapural, Christopher A. Gilmore, John Chae, Richard L. Rauck, Steven Cohen, Michael F. Saulino, Amorn Wongsarnpigoon, Meredith J. Mcgee, Joseph W. Boggs

Research output: Contribution to journalArticle

Abstract

As the leading cause of disability among U.S. adults, chronic low back pain (LBP) is one of the most prevalent and challenging musculoskeletal conditions. Neuromodulation provides an opportunity to reduce or eliminate the use of opioids to treat chronic LBP, but the cost and invasiveness of existing methods have limited its broad adoption, especially earlier in the treatment continuum. The present case report details the results of a novel method of short-term percutaneous peripheral nerve stimulation (PNS) in 2 subjects with chronic LBP. At the end of the 1-month therapy, stimulation was discontinued and the leads were withdrawn. PNS produced clinically significant improvements in pain (62% average reduction in Brief Pain Inventory Question #5, average pain), and functional outcomes (73% reduction in disability, Oswestry Disability Index; 83% reduction in pain interference, Brief Pain Inventory). Both subjects reduced nonopioid analgesic use by 83%, on average, and the one subject taking opioids ceased using all opioids. The only adverse event was minor skin irritation caused by a topical dressing. The clinically significant improvements were sustained at least 4 months after start of therapy (79% average reduction in pain; both reported minimal disability; 100% reduction in opioids; 74% reduction nonopioids). The results reveal the utility of this novel, short-term approach and its potential as a minimally invasive neuromodulation therapy for use earlier in the treatment continuum to produce sustained pain relief and reduce or eliminate the need for analgesic medications, including opioids, as well as more expensive and invasive surgical or therapeutic alternatives.

Original languageEnglish (US)
JournalPain Practice
DOIs
StateAccepted/In press - 2017

Fingerprint

Low Back Pain
Peripheral Nerves
Opioid Analgesics
Pain
Therapeutics
Non-Narcotic Analgesics
Equipment and Supplies
Bandages
Analgesics
Costs and Cost Analysis
Skin

Keywords

  • Back pain
  • Chronic pain
  • Disability
  • Non-narcotic
  • Nonopioid
  • Pain
  • Percutaneous
  • Peripheral nerve stimulation

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Percutaneous Peripheral Nerve Stimulation for the Treatment of Chronic Low Back Pain : Two Clinical Case Reports of Sustained Pain Relief. / Kapural, Leonardo; Gilmore, Christopher A.; Chae, John; Rauck, Richard L.; Cohen, Steven; Saulino, Michael F.; Wongsarnpigoon, Amorn; Mcgee, Meredith J.; Boggs, Joseph W.

In: Pain Practice, 2017.

Research output: Contribution to journalArticle

Kapural, Leonardo ; Gilmore, Christopher A. ; Chae, John ; Rauck, Richard L. ; Cohen, Steven ; Saulino, Michael F. ; Wongsarnpigoon, Amorn ; Mcgee, Meredith J. ; Boggs, Joseph W. / Percutaneous Peripheral Nerve Stimulation for the Treatment of Chronic Low Back Pain : Two Clinical Case Reports of Sustained Pain Relief. In: Pain Practice. 2017.
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