Treatment of chronic pain with neurostimulation

Many ablative techniques have been employed in the past to interrupt these signals. However, the results were often temporary and symptoms tended to recur. The more modern approach has suggested that modulation of the nervous elements may be a more resilient approach for treating such chronic pain disorders. We are realizing that many of these pain conditions are also dynamic and evolving, and as such need a similar treatment modality. Neurostimulation, thus, provides the ability of therapeutically dosing electrical current in a variety of pulse forms, amplitudes, pulse widths, and frequencies, to affect that system. Furthermore, it is not destructive, it is reversible, and it can be remotely adjusted and programmed over time; clear advantages to previous surgical therapies. This chapter reports on the current evidence for the use of neurostimulation (i.e. spinal cord stimulation, motor cortex stimulation and deep brain stimulation) in the treatment of chronic pain conditions.

Departments of Neurosurgery and Neurology, Thomas Jefferson University, Philadelphia, Pa., USA.

Note from Tim Brunson DCH: The reason that I included the stimulation is that it demonstrates the efficacy of stimulation of certain neural substrates and the relief of chronic pain. Hypnotherapists should not that other literature also supports activation and other alteration similarly by the use of altered states and guided imagery. We feel that there is a need to further study the impact of specific imagery techniques, such as imagining facial expressions, and the activation of specific substrates. While this may seem to be part of the neo-phrenology movement, we fully realize that neural function is multifaceted and integrated regardless of regional specialization.