Charles A Odonkor1, Tariq AlFarra2, Peju Adekoya3, Vwaire Orhurhu4, Tomás Rodríguez5, Emily Sottosanti6, Alan D Kaye7. 1. Department of Orthopaedics and Rehabilitation, Division of Physiatry, Interventional Pain Medicine, Yale University School of Medicine, New Haven, CT, USA. charles.odonkor@yale.edu. 2. Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 3. Department of Anesthesia and Critical Care, Division of Pain Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 4. Department of Anesthesia, Critical Care and Pain Medicine, Division of Pain, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. 5. Therapeutics Institute, University of Massachusetts Medical School, MA, Worcester, USA. 6. Department of Anesthesiology, Beth Israel Deaconess Medical Center, Critical Care and Pain, Harvard Medical School, Boston, MA, USA. 7. Department of Anesthesiology, Louisiana State University Health Sciences Center, Shreveport, LA, USA.
Abstract
PURPOSE OF REVIEW: The main objective of this review is to appraise the literature on the role of spinal cord stimulation (SCS), cannabinoid therapy, as well as SCS and cannabinoid combination therapy for the management of chronic neuropathic and nociceptive pain. Current research suggests that SCS reduces pain and increases functional status in carefully selected patients with minimal side effects. RECENT FINDINGS: As cannabinoid-based medications become a topic of increasing interest in pain management, data remains limited regarding the clinical efficacy of cannabinoids for pain relief. Furthermore, from a mechanistic perspective, although various pain treatment modalities utilize overlapping pain-signaling pathways, clarifying whether cannabinoids work synergistically with SCS via shared mechanisms remains to be determined. In considering secondary outcomes, the current literature suggests cannabinoids improve quality of life, specifically sleep quality, and that SCS decreases opioid consumption, increases functional capacity, and decreases long-term healthcare costs. These findings, along with the high safety profiles of SCS and cannabinoids overall, incentivize further exploration of cannabinoids as an adjunctive therapy to SCS in the treatment of neuropathic and nociceptive pain.
PURPOSE OF REVIEW: The main objective of this review is to appraise the literature on the role of spinal cord stimulation (SCS), cannabinoid therapy, as well as SCS and cannabinoid combination therapy for the management of chronic neuropathic and nociceptive pain. Current research suggests that SCS reduces pain and increases functional status in carefully selected patients with minimal side effects. RECENT FINDINGS: As cannabinoid-based medications become a topic of increasing interest in pain management, data remains limited regarding the clinical efficacy of cannabinoids for pain relief. Furthermore, from a mechanistic perspective, although various pain treatment modalities utilize overlapping pain-signaling pathways, clarifying whether cannabinoids work synergistically with SCS via shared mechanisms remains to be determined. In considering secondary outcomes, the current literature suggests cannabinoids improve quality of life, specifically sleep quality, and that SCS decreases opioid consumption, increases functional capacity, and decreases long-term healthcare costs. These findings, along with the high safety profiles of SCS and cannabinoids overall, incentivize further exploration of cannabinoids as an adjunctive therapy to SCS in the treatment of neuropathic and nociceptive pain.
Authors: M A Kemler; G A Barendse; M van Kleef; H C de Vet; C P Rijks; C A Furnée; F A van den Wildenberg Journal: N Engl J Med Date: 2000-08-31 Impact factor: 91.245
Authors: Timothy Deer; Konstantin V Slavin; Kasra Amirdelfan; Richard B North; Allen W Burton; Thomas L Yearwood; Ed Tavel; Peter Staats; Steven Falowski; Jason Pope; Rafael Justiz; Alain Y Fabi; Alexander Taghva; Richard Paicius; Timothy Houden; Derron Wilson Journal: Neuromodulation Date: 2017-09-29