Abstract
Background: Chronic pain remains one of the most prevalent and debilitating conditions globally, severely impacting quality of life and productivity. Recent advances in pain management, particularly neuromodulation, have introduced innovative solutions for addressing both acute and chronic pain. Among these, spinal cord stimulation (SCS) stands out as a transformative modality, offering effective relief through novel technologies and expanding clinical applications.
Aims: This review highlights recent advances in pain management with a special focus on spinal cord stimulation. It explores technological innovations, expanded indications and clinical outcomes, emphasizing its role a promising modality for chronic pain management.
Methods: The review examines innovations in neuromodulation, such as SCS waveforms, device miniaturization, and closedloop systems. Advances in related modalities, such as dorsal root ganglion stimulation (DRGS), peripheral nerve stimulation (PNS), and sacroiliac (SI) joint fusion, are also discussed. Clinical studies on efficacy, patient satisfaction, and cost-effectiveness are analyzed to contextualize SCS within broader pain management strategies.
Results: Recent advancements in SCS technology, including high-frequency stimulation (HF10), burst therapy and closedloop systems have revolutionized chronic pain management by improving efficacy, comfort, and personalization. Expanded indications for SCS now encompass conditions such as persistent spine pain syndrome (PSPS), complex regional pain syndrome (CRPS), and painful diabetic neuropathy (PDN). Related modalities like DRGS and PNS provide targeted solutions for specific pain syndromes while innovations in telemedicine and biotechnology are enhancing accessibility. Despite these breakthroughs, challenges such as high costs, limited accessibility, and device-specific complications remain.
Conclusions: Spinal cord stimulation is a promising modality in recent pain management advancements offering tailored and effective solutions for diverse pain conditions. Complemented by other neuromodulation and surgical innovations, SCS has significantly improved patient outcomes and quality of life. While challenges persist, ongoing technological and clinical advancements ensure a bright future for personalized pain management. Addressing barriers to accessibility and cost will be key to maximizing the impact of these innovations. This review article aims to bridge this gap in knowledge.