Dr Simon Thomson
Consultant in Pain Medicine, Mid and South Essex Hospitals Trust
Dr Ganesan Baranidharan
Consultant in Pain Medicine, The Leeds Teaching Hospitals Trust
A smart method of spinal cord stimulation means more accurate therapy dosing for patients and objective data, allowing physicians to monitor their holistic wellbeing more precisely.
Advances in technology for the treatment of chronic nerve pain are helping bring welcome relief to many patients as well as improving their quality of life.
Clinicians are also using the technology to customise treatment. They are harnessing the objective data they are now able to retrieve from a smart Spinal Cord Stimulation (SCS) system to help them further refine the targeting and tailoring of treatment for their patients.
Since using Saluda Medical’s Evoke® System, the first and only Smart SCS™ available in the UK, leading physicians in the field of pain medicine have reported some dramatic changes to the lives of sufferers.
Electrical pulses for pain relief
SCS is a safe and effective treatment that has been in use for more than 55 years and uses a small, implantable device to deliver tiny electrical pulses to the spinal cord. These pulses interrupt your body’s pain signals to reduce the sensation of pain before they travel up your spinal cord and reach your brain.
The difference with the Evoke® system is that it can listen to how your body reacts to these pulses and auto-adjusts the stimulation levels 40+ times a second, to ensure the individualised dose is delivered as prescribed by the physician.
Carol Mortley, a patient in her 60s who was unable to get a referral from her local pain service, was desperate to live without excruciating pain. After her husband read an article about the work of Dr Simon Thomson, Consultant in Pain Medicine, Mid and South Essex NHS Foundation Trust, the couple went to see him.
One of the big advantages of this system is that for the first time, if the patient comes back for reprogramming, we now have objective information on the body’s response to stimulation that can tell us if everything is working as it should be.
Dr Ganesan Baranidharan
Dr Thomson says: “We managed to get her treatment funded through the NHS. She is now recording a 90% pain relief, much-improved quality of life and is very happy with it.”
Dr Thomson says that with older SCS systems, the stimulation patients received could vary as they moved or even coughed or sneezed; and often, they would adjust it themselves to try and help with their pain. However, this could result in them not getting the right levels of therapy that the physicians prescribed.
This system allows for neuro-monitoring, enabling clinicians to see exactly what levels of therapy patients are allowing themselves.
Complexity of chronic pain
Dr Ganesan Baranidharan, Consultant in Pain Medicine at The Leeds Teaching Hospitals, has treated more than 40 cases with the new Smart SCS system.
“One of the big advantages of this system is that for the first time, if a patient comes back for reprogramming, we now have objective information on the body’s response to stimulation that can tell us if everything is working as it should be,” he says. Acknowledging that SCS as a treatment for severe nerve pain may not work for everybody, he is confident that it is effective in over 70% of patients. “But whatever the percentage of pain relief, there will be improvements in quality of life, as seen in the Evoke study, with patients seeing meaningful improvement in pain, mood, sleep, function or quality of life.”
Dr Thomson explains that chronic pain is complex and not just about measuring pain intensity but about multidimensional improvements in patient outcomes including pain relief, functional ability, quality of life as well as improvements in mood and sleep. For instance, one person might get improved pain control, but it doesn’t make any difference to their lifestyle, whereas another might not have had much pain reduction but are now able to walk.
Tool to guide the pathway
Despite being available through the NHS, there is often a lack of access pathways and knowledge about when to escalate a patient. Consequently, the SCS E-health tool has been developed to help GPs determine if their patient is appropriate for referral. Hopefully, with this tool, more physicians and their teams can see an end to debilitating chronic pain.
