A Case of Long-Term Treatment of Chronic Pain Syndrome by Anodal tDCS of the Motor Cortex, Previously Resistant to High-Frequency rTMS and Implanted Spinal Cord Stimulation

2016 ◽  
Vol 9 (4) ◽  
pp. 618-620 ◽  
Author(s):  
Hasan Hodaj ◽  
Jean-François Payen ◽  
Jean-Pascal Lefaucheur
Keyword(s):  
Spinal Cord ◽  
Chronic Pain ◽  
Motor Cortex ◽  
High Frequency ◽  
Pain Syndrome ◽  
Term Treatment ◽  
Anodal Tdcs ◽  
Chronic Pain Syndrome ◽  
Long Term Treatment

Immersive Virtual Reality as a Non-Pharmacological Analgesic for Pain Management

2018 ◽  
pp. 1176-1199
Author(s):  
Diane Gromala ◽  
Xin Tong ◽  
Chris Shaw ◽  
Weina Jin
Keyword(s):  
Chronic Pain ◽  
Virtual Reality ◽  
Virtual Environments ◽  
Acute Pain ◽  
Term Treatment ◽  
Immersive Virtual Reality ◽  
Effective Form ◽  
Long Term Treatment ◽  
Difficult Challenge

In the 1990s, when immersive Virtual Reality (VR) was first popular, researchers found it to be an effective intervention in reducing acute pain. Since that time, VR technologies have been used for treating acute pain. Although the exact mechanism is unclear, VR is thought to be an especially effective form of pain distraction. While pain-related virtual environments have built upon pain distraction, a handful of researchers have focused on a more difficult challenge: VR for long-term chronic pain. Because the nature of chronic pain is complex, pharmacological analgesics are often insufficient or unsustainable as an ideal long-term treatment. In this chapter, the authors explore how VR can be used as a non-pharmacological adjuvant for chronic pain. Two paradigms for virtual environments built for addressing chronic pain have emerged – Pain Distraction and what we term Pain Self-modulation. We discuss VR's validation for mitigating pain in patients who have acute pain, for those with chronic pain, and for addressing “breakthrough” periods of higher pain in patients with chronic pain.

An Evaluation of the Long-Term Treatment Outcomes of an Interdisciplinary Chronic Pain Centre Program

2011 ◽  
Vol 19 (3) ◽  
pp. 134-143 ◽  
Author(s):  
Flo Wagner ◽  
Bonnie Janzen ◽  
Gregg Tkachuk ◽  
William Laverty ◽  
Marc Woods
Keyword(s):  
Chronic Pain ◽  
Treatment Outcomes ◽  
Term Treatment ◽  
Pain Centre ◽  
Long Term Treatment

scholarly journals Complex Regional Pain Syndrome and Failed Back Surgery Syndrome With Failed High-Frequency Spinal Cord Stimulation Salvaged With Arthrodesis Revision Surgery and Burst Therapy

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Erin McCormack ◽  
Mansour H Mathkour ◽  
Lora Wallis Kahn ◽  
Maged Guirguis ◽  
Gassan Chaiban ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Chronic Pain ◽  
Back Pain ◽  
Pain Relief ◽  
High Frequency ◽  
Pain Syndrome ◽  
Failed Back Surgery Syndrome ◽  
Foot Pain ◽  
Failed Back Surgery ◽  
Back Surgery

Abstract INTRODUCTION Complex regional pain syndrome (CRPS) is a disabling form of constant and intense chronic pain involving a limb. Failed back surgery syndrome (FBSS) is chronic back pain following back surgery. Burst stimulation is a novel concept applied recently to treat chronic pain through spinal cord stimulation (SCS). The impulses are thought to travel to the thalamus to treat sensory, affective, and attentional components of neuropathic pain by targeting both the somatosensory cortex and the limbic system. METHODS A 50-yr-old female presented 1 yr after L5-S1 posterior instrumentation and posterolateral arthrodesis for spondylolisthesis with disabling Type I CRPS of her left foot and back pain. Postoperative improvement in back pain was noted but her left leg pain became worse despite SCS reprogramming. Two months later, she underwent placement of a different paddle lead at T12 and a new pulse generator using burst therapy. This resulted in complete resolution of foot pain. She remains pain-free 5 mo postoperatively. RESULTS Our patient underwent a T9-T10 high frequency (10 kHz) SCS trial followed by permanent paddle lead placement at T9-10 which provided more than 50% foot pain relief resulting in improved range of motion. However, worsening back pain and pseudoarthrosis mandated a revision of her prior arthrodesis 6 mo after SCS surgery. CONCLUSION In selected patients with FBSS and CRPS, revision of arthrodesis combined with SCS may be needed to achieve adequate pain relief. Burst therapy may be superior to high frequency stimulation in select patients.

scholarly journals Nimodipine Promotes Functional Recovery After Spinal Cord Injury in Rats

2021 ◽  
Vol 12 ◽  
Author(s):  
Fangliang Guo ◽  
Xiaolong Zheng ◽  
Ziyu He ◽  
Ruoying Zhang ◽  
Song Zhang ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Motor Neurons ◽  
Hind Limb ◽  
Term Treatment ◽  
Bladder Function ◽  
Lumbar Spinal Cord ◽  
Long Term Treatment ◽  
Cord Injury ◽  
Lumbar Spinal

Spinal cord injury (SCI) is a devastating condition that results in severe motor, sensory, and autonomic dysfunction. The L-/T-type calcium channel blocker nimodipine (NMD) exerts a protective effect on neuronal injury; however, the protective effects of long-term administration of NMD in subjects with SCI remain unknown. Thus, the aim of this study was to evaluate the role of long-term treatment with NMD on a clinically relevant SCI model. Female rats with SCI induced by 25 mm contusion were subcutaneously injected with vehicle or 10 mg/kg NMD daily for six consecutive weeks. We monitored the motor score, hind limb grip strength, pain-related behaviors, and bladder function in this study to assess the efficacy of NMD in rats with SCI. Rats treated with NMD showed improvements in locomotion, pain-related behaviors, and spasticity-like symptoms, but not in open-field spontaneous activity, hind limb grip strength or bladder function. SCI lesion areas and perilesional neuronal numbers, gliosis and calcitonin gene-related peptide (CGRP+) fiber sprouting in the lumbar spinal cord and the expression of K+–Cl− cotransporter 2 (KCC2) on lumbar motor neurons were also observed to further explore the possible protective mechanisms of NMD. NMD-treated rats showed greater tissue preservation with reduced lesion areas and increased perilesional neuronal sparing. NMD-treated rats also showed improvements in gliosis, CGRP+ fiber sprouting in the lumbar spinal cord, and KCC2 expression in lumbar motor neurons. Together, these results indicate that long-term treatment with NMD improves functional recovery after SCI, which may provide a potential therapeutic strategy for the treatment of SCI.

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