High-frequency spinal cord stimulation: An emerging treatment option for patients with chronic pain

Chronic pain is a complex syndrome estimated to affect over 100 million Americans. Pharmaceutical-based therapy, including the use of opioids, is widely accepted as a primary treatment strategy but is associated with addiction, overdose, and diversion risk. Spinal cord stimulation (SCS) is a well-established, device-based alternative for pain management. Though effective in treating leg pain, traditional SCS has been much less effective at achieving long-term back-pain relief. In addition, stimulation with traditional SCS often leads to tingling sensations and inadvertent postural-related shocks that many patients find unpleasant. A newly developed SCS system (Nevro Corp., Menlo Park, CA) shows promise in addressing these limitations. This new device is similar to traditional SCS systems but is able to stimulate at much higher frequencies, up to 10 kHz. Prospective clinical studies of high-frequency SCS (HF-SCS) suggest improved effectiveness in treating chronic low-back pain and other types of pain that often do not respond well to traditional SCS. In addition, HF-SCS appears capable of delivering pain relief without paresthesia, both simplifying the implant procedure and improving patient satisfaction. The system is currently undergoing study in a multicenter, randomized controlled clinical trial in the United States. If the results are positive, HF-SCS could represent an important advancement in the treatment of chronic pain.