A pilot study of neuromuscular electrical stimulation for neuropathic pain caused by spinal cord injury

Medicine, 2018 · DOI: http://dx.doi.org/10.1097/MD.0000000000011658 · Published: August 3, 2018

Spinal Cord Injury Neurology Pain Management

Simple Explanation

This study investigated whether neuromuscular electrical stimulation (NMES) could help manage neuropathic pain (NPP) caused by spinal cord injury (SCI). Researchers compared a group receiving carbamazepine plus NMES to a group receiving carbamazepine alone. Pain intensity was measured using a numerical rating scale (NRS), and quality of life was assessed using the Short Form 36 (SF-36) Scale. Adverse events were also tracked. The study found that NMES did not significantly reduce pain or improve quality of life compared to the control group after 3 months. The researchers suggested that the NMES treatment might not have been strong enough.

Study Duration

3 months

Participants

54 patients with neuropathic pain after spinal cord injury

Evidence Level

Not specified

Key Findings

1
NMES did not reduce pain intensity of NPP, measured by the NRS, compared with cases in the control group.
2
NMES did not improve the quality of life, measured by the SF-36, compared with cases in the control group.
3
Both groups had similar adverse events.

Research Summary

This pilot study retrospectively investigated the feasible effect and safety of neuromuscular electrical stimulation (NMES) for the management of neuropathic pain (NPP) caused by spinal cord injury (SCI). The results of this study did not demonstrate that patients in the NMES group showed greater effectiveness in pain relief of NPP, measured by NRS, and quality of life improvement, as measured by the SF-36 score, when compared with the patients in the control group. This pilot study showed that NMES might not beneﬁt for patients with NPP following SCI after 3 months treatment with quite low intervention dose.

Practical Implications

Limited Efficacy

NMES may not be effective for treating neuropathic pain caused by spinal cord injury when administered at a low intervention dose.

Further Research Needed

Future studies should explore higher doses or different protocols of NMES to determine its potential effectiveness.

Alternative Treatments

Clinicians should consider alternative or adjunctive treatments for neuropathic pain in SCI patients, as NMES at this dosage did not show significant benefits.

Study Limitations

1
The doses of NMES were twice weekly for a total of 3 months, which may be insufﬁcient for patients with NPP after SCI.
2
The outcome results were the combination of NMES and carbamazepine, but not the NMES alone, which may difﬁcult to identify the effectiveness and safety of NMES alone in this study.
3
This pilot study had an intrinsic limitation because of the retrospective study, which may increase the risk of selection.

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