With an implanted device that modifies or blocks nerve activity, the spinal cord stimulation (SCS) for chronic pain involves injecting low amounts of electricity into the spinal cord to reduce the sensation of pain reaching the brain. This method is most often used after nonsurgical pain treatment methods have failed to provide sufficient relief.
According to a new study published in the journalBioelectronic Medicine on April 28, 2022, high-frequency SCS demonstrated more effective in perceived pain reduction (PPR) than low-frequency SCS in patients, although there were differences in PPR between male and female patients.
In 1989, the Food and Drug Administration approved high-frequency SCS (10,000 Hz) that delivers electrical stimulation pulses that are shorter in length, less in amplitude, and do not cause paresthesia. Symptoms of tingling or prickling were also evident.
94 patients (40 females, 54 males) who received HF-SCS and 143 patients (70 females and 73 males) who received LF-SCS were examined after their initial tests. PPR across all patients improved at three and six months post-implantation, but HF-SCS increased by contrast with LF-SCS. HF-SCS was also associated with less subsequent use of opioids to alleviate pain.
However, there were differences in the findings between sexes:
- 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.
UC San Diego Health''s senior author claims that sex specific immune pathways are differentially linked to chronic pain symptoms, and that there are no differences in spinal cord stimulation efficacy or opioid use among those found.
It''s a first step in the right direction, but more work should be done to carefully define sex specific pain regulatory pathways that might be helpful to specific types of neuromodulation and pharmaceutical therapies.
All of them are UC San Diego; Jacob Caylor, UC San Diego and Northwest Pain Care, Spokane, WA; Christina L. Cui, Duke University; and Eric Nelson, Pacific Western University of Health Sciences.