Clinical Applications of Neuromodulation: Spinal Cord Stimulation for Abdominal Pain

Chapter

Abstract

Chronic abdominal pain poses significant challenges to patients and physicians alike. For patients, pain can limit both professional and personal quality of life. It results in increased doctor visits, imaging and surgery interventions that frequently fail to find a cause or provide relief. For physicians, identification of etiology is fraught with difficulty, largely due to the fact that visceral pain is frequently diffuse and is poorly localized and referred to somatic structures. Abdominal pain is one of the most common complaints for primary care visits and is the leading reason for gastroenterological consultation. These challenges taken together with the high prevalence, frequent office visits and extensive work-up, as well as decreases in productivity, work hours, and socioeconomic status, make chronic abdominal pain a significant burden on the patient, physician, healthcare system, and society as a whole. In the United States alone, between 20 and 45 % of Americans will suffer from chronic visceral pain, of these only 50–70 % will have a definitive etiology of their pain identified. Recent research has provided data helping to better elucidate visceral pain pathways and the dorsal column’s role in not only transmission but also amplification of visceral pain. Exciting data in both animal models and human subjects has demonstrated that spinal cord stimulation of the dorsal horn can provide analgesia for chronic visceral pain and improve both quality of life and functional status.

Keywords

Migration Ischemia Morphine Pancreatitis Gastroparesis 

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Copyright information

© American Academy of Pain Medicine 2013

Authors and Affiliations

  1. 1.Department of Carolinas Pain Institute, Center for Clinical ResearchWake Forest Baptist Medical CenterWinston SalemUSA
  2. 2.Department of AnesthesiologyWake Forest Baptist Medical CenterWinston-SalemUSA

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