After nonsurgical pain treatment methods have failed to provide sufficient relief, the approach consists of sending low amounts of electricity directly into the spinal cord, which then alters or blocks nerve activity.
A research team led by scientists at the University of California San Diego School of Medicine found that high-frequency SCS improved perceived pain reduction (PPR) than low-frequency SCS in subjects studied, and that there was a decrease in PPR among male and female patients.
In 1989, the FDA approved high-frequency SCS (10,000 Hz) to treat painful back and leg pain. In 2016, the FDA approved high-frequency SCS, which measures 2,500 times longer in length and is less short in length in amplitude and does not induce paresthesia.
94 patients (40 females, 54 males) who received HF-SCS, and 143 patients (70 females and 73 males) who received LF-SCS were assessed following the birth of the researchers, although HF-SCS showed higher PPR than LF-SCS. HF-SCS was also associated with a reduction in subsequent use of opioids to alleviate pain.
Despite differences in conclusions between men and women, there was also conflict.
- Male PPR, for example, was significantly better for HF-SCS at three and six months when compared to LF-SCS, while this was only true for females at the 6 month time point.
- LF-SCS males used more opioids post-implantation and at six months while females used more opioids post-implantation, at three, six and tended to use more opiates at the 12-month time-point.
According to a new study, sex-specific immune pathways also contribute to chronic pain symptoms, according to Imanuel Lerman, MD, an associate professor of anesthesiology, pain management specialist at UC San Diego Health and an affiliate of the Qualcomm Institute. The observed parameter-specific (high versus low frequency) sex-based differences in spinal cord stimulation efficacy and opiate use are absolutely intriguing.
It''s a first step in the right direction, but more work must be done in order to properly characterize sex specific pain regulatory pathways that may be responsive to specific types of neuromodulation and pharmaceutical therapies.
All of these authors are at UC San Diego; Jacob Caylor, UC San Diego and Northwest Pain Care, Spokane, WA; Christina L. Cui, Duke University, and Eric Nelson of the Pacific Western University of Health Sciences.