High-Frequency Spinal Cord Stimulation Relieves Chronic Back and Leg Pain

A new high-frequency form of spinal cord stimulation (SCS) therapy may offer patients effective long-term relief from chronic back and leg pain without the unwanted side effects of traditional forms of SCS therapy, according to a new study in the journal Anesthesiology.

An increasingly common treatment option for chronic back and leg pain sufferers, SCS delivers electric pulses to the spinal cord via a small device implanted under the skin. While traditional SCS uses frequencies of 40 to 60 Hz, HF10 therapy delivers high-frequency pulses of 10,000 Hz.
________________________________________________________________________________________________________________________________________________________________________

RELATED CONTENT
What's Causing This Man's Low Back Pain?
Low Back Pain: 8 Questions Physicians Often Ask
________________________________________________________________________________________________________________________________________________________________________

The first prospective study to directly compare SCS therapies, SENZA-RCT demonstrated that patients experienced significantly greater, long-term relief with HF10 therapy when compared to a traditional low-frequency form of SCS therapy

“HF10 therapy is the only SCS therapy indicated by the FDA to deliver pain relief without paresthesia, a constant tingling sensation that is the basis of traditional SCS,” says lead study author Leonardo Kapural, MD, PhD, professor of anesthesiology at Wake Forest University School of Medicine and clinical director at Carolinas Pain Institute at Brookstown in Winston-Salem, N.C.

“Considering that previous studies using traditional stimulation suggested intolerance to paresthesias in the majority of the patients when spinal cord stimulation is used long-term, such an approach seems to be a welcome departure,” he says.

Kapural and his colleagues studied 171 patients with chronic back or leg pain who had an SCS system implanted at one of 10 comprehensive pain treatment centers. A group of 90 patients received HF10 therapy, while 81 patients had traditional SCS.

After 3 months, 85% of back pain and 83% of leg pain patients in the HF10 therapy group experienced a 50% or greater reduction in pain. Meanwhile, only 44% of back pain and 56% of leg pain patients in the traditional SCS group experienced a 50% reduction in pain.

“The efficacy demonstrated by HF10 therapy for back pain is especially notable as back pain has not historically been treated efficaciously with traditional SCS,” Kapural says. “As a comparator, historical studies in the space have demonstrated a 50% response rate for leg pain and lower for back pain.”

HF10 therapy also remained more effective than traditional SCS over the 12-month study period, and two-thirds of the HF10 therapy patients reduced their pain scores to less than or equal to 2.5 on the visual analog scale for pain, a 1-to-10 scale.

Kapural and his team are currently looking into other indications where such therapy can be used.

“Also, the SENZA study provoked much interest, and new research in the area of novel waveforms applied to control chronic pain from all major players in the field was initiated. We are the part of some of those studies as well,” he says.

—Colleen Mullarkey

Reference

Kapural L, Yu C, Doust MW, Gliner BE, Vallejo R, Sitzman BT, et al. Novel 10-kHz high-frequency therapy (HF10 Therapy) is superior to traditional low-frequency spinal cord stimulation for the treatment of chronic back and leg pain: The SENZA-RCT randomized controlled trial. Anesthesiology. 2015 Jul 27. [Epub ahead of print]