Self-Assessment: Neuromodulation in Pain Management | Lifestyle Medicine for Common Conditions Encountered in the EDX Laboratory-Dr. Carrion-Jones Presentation

Dr. Carrion-Jones Presentation

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Dr. Monica Carrion-Jones, associated with Jax Spine and Pain Centers and Centurion Spine and Pain Centers, delivered a comprehensive presentation on neuromodulation therapy in pain management. The objectives focused on understanding the mechanisms, benefits, and indications of various neuromodulation therapies such as Spinal Cord Stimulation (SCS), Dorsal Root Ganglion Stimulation (DRGS), and Peripheral Nerve Stimulation (PNS) for chronic pain management.<br /><br />Neuromodulation, defined as the electrical stimulation of the nervous system to modulate pain perception, has a rich history dating back to the first-century Roman physician Scribonius Longus. Key developments include the gate control theory by Melzach and Wall in 1965 and the introduction of implantable spinal cord stimulators in the late 1960s.<br /><br />Spinal Cord Stimulation functions by inhibiting or facilitating afferent impulses within the dorsal horn, targeting large-diameter fibers to "close the gate" to pain transmission. High-frequency (10 kHz) and BurstDR SCS are advancements that offer paresthesia-free pain relief by imitating natural neuronal firing patterns, modulating both physical and emotional pain pathways in the brain.<br /><br />While traditional tonic SCS shows a success rate of 50-70%, high-frequency and BurstDR modalities address limitations such as unsatisfactory coverage of difficult-to-reach areas and unpleasant paresthesia. DRGS, being low-energy and paresthesia-free, specifically treats focal pain areas like the groin and foot with higher precision and reduced energy consumption.<br /><br />In the context of diabetic peripheral neuropathy (DPN), SCS and DRGS have shown efficacy in managing pain where conventional therapies have failed. Various randomized controlled trials (RCTs) highlight significant pain relief with SCS for refractory DPN patients, supporting its application as an effective treatment modality.<br /><br />Peripheral Nerve Stimulation offers minimally invasive, targeted pain relief and requires thorough patient selection based on chronic pain documentation and psychological screening.<br /><br />Dr. Carrion-Jones' presentation encouraged feedback through the AANEM app and emphasized the importance of claiming CME credits before December 15, 2023. She extended special thanks to her colleagues and collaborators for their contributions to the field of neuromodulation.

Keywords

neuromodulation

pain management

Spinal Cord Stimulation

Dorsal Root Ganglion Stimulation

Peripheral Nerve Stimulation

chronic pain

diabetic peripheral neuropathy

high-frequency SCS

BurstDR SCS

CME credits