Chapter 115 - Spinal Cord Stimulation for Chronic Abdominal Pain

Abstract

In the United States alone, between 20% and 45% of population will suffer from chronic visceral pain during their lifetime. Fewer than 50%–70% of the patients will have a definitive etiology of their pain identified. Chronic abdominal pain has a negative impact on the patient's socioeconomic status, frequently produces strong affective responses, and is a major burden on the healthcare system. Recent research has provided data helping to better elucidate visceral pain pathways. Exciting data in both animal models and human subjects has demonstrated that the spinal cord stimulation (SCS) of the dorsal horn and column can provide analgesia for chronic visceral pain, and improve both quality of life (QOL) and functional status. Animal studies suggest that SCS suppresses visceral hyperalgesia. Published larger case series on use of SCS for the treatment of chronic abdominal pain suggested a significant long-term relief from chronic pain. Given the limitations of conservative and surgical treatments for chronic visceral pain, SCS may be a useful therapeutic option. Upcoming trials focus on new modalities and delivered waveforms of SCS to provide better pain relief and functional capacity improvement.