New Guidelines for Neurostimulation Therapy for Chronic Pain

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There is a need for guidance regarding safety and risk reduction for implantable neurostimulation devices, according to a panel of experts from the International Neuromodulation Society (INS).

The INS created the Neuromodulation Appropriateness Consensus Committee (NACC), which performed a literature review to evaluate ways to reduce risks of neurostimulation therapies. The panel collected evidence by searching MEDLINE, PubMed, and Google Scholar. In addition to the evidence from the literature, the NACC drew on clinical experience from the convened consensus panel in order to come up with their final recommendations for improving safety and reducing risks of neurostimulation in the treatment of chronic pain and ischemic diseases.

The NACC determined that reducing the risk associated with neurostimulation devices is both valuable and possible with best practice. While device-related complications are not uncommon, they are becoming less frequent with improvements to technology and surgical skills. 

Neurostimulation shows efficacy in the treatment of failed back surgery and complex regional pain syndrome, however more randomized controlled studies are needed to determine its effectiveness in treating peripheral neuropathic pain, postamputation pain, postherpetic neuralgia and other nerve injuries. Other uses, including the treatment of congestive heart failure, are being investigated. 

The panel has recommended several practice modifications for improved care and has outlined minimum training standards necessary to become an implanting physician.

Nerve Damage Might Explain Chronic Pain
New Guidelines for Neurostimulation Therapy for Chronic Pain

The International Neuromodulation Society formed a panel of experts to conduct a literature review on the appropriate and effective use of neurostimulation therapies. The Neuromodulation Appropriateness Consensus Committee developed guidelines for implanting physicians and found that the therapy is successful in the treatment of failed back surgery syndrome and complex regional pain syndrome.

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