Spinal Cord Stimulation vs Pain Pump for Chronic Back Pain

This trial compares two treatments to determine which provides better relief for chronic low back pain: spinal cord stimulation (SCS) and a pain pump. Both treatments involve implanted devices, but their relative effectiveness remains unclear. Participants will try both treatments to identify which alleviates their pain the most. The trial suits individuals who have undergone previous back surgeries, experience more pain in their back than in their legs, and have not found relief from other treatments like physical therapy or medications. As a Phase 4 trial, the treatments are already FDA-approved and proven effective, allowing researchers to understand how they benefit more patients.

The trial does not specify if you need to stop your current medications, but it does require that patients using more than 15 mg of oral morphine daily reduce their dosage below that level for at least 4 weeks before the test date.

A previous study found that using a pain pump with bupivacaine and fentanyl provided excellent pain relief for most patients, with no serious side effects reported. Another study showed that injecting bupivacaine into the spinal canal effectively relieved pain, with rare complications.

Research has shown that spinal cord stimulation (SCS) is generally safe and well-tolerated, with many patients experiencing significant pain reduction and continuing to use their devices for several years. However, one review noted limited clinical data on its long-term effectiveness for back pain.

Researchers are excited about spinal cord stimulation (SCS) and pain pumps for chronic back pain because they offer different ways to tackle pain management. Unlike oral medications, which are a common treatment, SCS uses electrical impulses to interfere with pain signals before they reach the brain, offering a non-drug approach to relief. Pain pumps, on the other hand, deliver medication directly to the spinal fluid, allowing for lower doses and potentially fewer side effects compared to systemic drugs. Both methods aim to provide targeted pain relief, which could lead to better outcomes and improved quality of life for patients.

This trial will compare spinal cord stimulation (SCS) with the use of a pain pump for managing chronic back pain. Studies have shown that SCS can effectively reduce chronic pain, with 60% of patients experiencing a significant decrease in back pain. In this trial, some participants will receive SCS, while others will receive treatment with a pain pump, which delivers medication directly to the spine and effectively manages chronic low back pain. Most patients report good-to-excellent pain relief with this method. Both treatments offer benefits, and the choice may depend on individual response.⁶⁷⁸⁹¹⁰