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The following is a summary of “A sham-controlled, randomized trial of spinal cord stimulation for the treatment of pain in chronic pancreatitis,” published in the July 2024 issue of Pain by Gulisano et al.

Spinal cord stimulation (SCS) is being explored as a treatment for pain in patients with chronic pancreatitis (CP) unresponsive to standard therapies, though evidence from sham-controlled trials is lacking.

Researchers conducted a retrospective study assessing the efficacy of SCS for pain management in patients with CP.

They included 16 patients of CP with inadequate pain relief. Participants underwent high-frequency (1000 Hz) paraesthesia-free SCS or a sham treatment for two separate 10-day stimulation periods, with a 3-day washout interval. Daily pain intensity recorded in a pain diary using a numeric rating scale (NRS) was accounted as the primary outcome, while secondary outcomes included questionnaires and quantitative sensory testing before and after interventions.

The result showed the baseline average daily pain score was 5.2 ± 1.9 on the NRS score. Post-spinal cord stimulation, the pain score was 4.2 ± 2.1 compared to 4.3 ± 2.1 in the sham group (mean difference −0.1, 95% CI [−1.4 to 1.1]; P=0.81). No group differences were found for maximal daily pain score, secondary outcomes, or quantitative sensory testing parameters. During the open-label extension, average daily NRS decreased from 5.2 ± 1.7 at baseline to 3.2 ± 1.8 at 3 months, 2.9 ± 1.9 at 6 months, and 3.4 ± 2.2 at 12 months (P=0.001).

Investigators concluded that the initial sham-controlled trial of SCS in painful CP showed no short-term pain relief with paraesthesia-free high-frequency (1000 Hz) stimulation, highlighting the need for larger trials with long-term follow-up to assess the actual effects.

Source: onlinelibrary.wiley.com/doi/full/10.1002/ejp.2315