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

Percutaneous Peripheral Nerve Stimulation for the Treatment of Chronic Low Back Pain: Two Clinical Case Reports of Sustained Pain Relief.
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Kapural L, Gilmore CA, Chae J, Rauck RL, Cohen SP, Saulino MF, Wongsarnpigoon A, McGee MJ, Boggs JW,


Kapural L, Gilmore CA, Chae J, Rauck RL, Cohen SP, Saulino MF, Wongsarnpigoon A, McGee MJ, Boggs JW, (click to view)

Kapural L, Gilmore CA, Chae J, Rauck RL, Cohen SP, Saulino MF, Wongsarnpigoon A, McGee MJ, Boggs JW,

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Pain practice : the official journal of World Institute of Pain 2017 03 14() doi 10.1111/papr.12571
Abstract

As the leading cause of disability among U.S. adults, chronic low back pain (LBP) is one sof 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 At the end of the 1-month therapy, stimulation was discontinued and the leads were withdrawn.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 non-opioid 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 non-opioids). 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. This article is protected by copyright. All rights reserved.

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