Rehabilitation perspectives of neuromodulation.
Chronic pain is one of the most prevalent and costly health care problems in the United States today. Two conditions, failed back surgery syndrome (FBSS) and complex regional pain syndrome (CRPS), in particular have been difficult to manage, resulting in increased disability and poorer quality of life measures for patients as well as increased treatments cost for payers. Given the cost of chronic pain management and overall subjectivity of analog pain scores, many payers are emphasizing the importance of functional outcomes as a means of assessing efficacy of treatment. Neuromodulation devices such as spinal cord stimulators are shown to be cost effective and able to improve functional outcomes and quality of life. Specific rehabilitation therapies also demonstrate improved functional outcomes. This article aims to discuss the role of rehabilitation in the patient with a neuromodulatory device. From the available data and our clinical experience, we recommend incorporating rehabilitation after placement of a neuromodulation device in order to optimize functional outcomes.
Pain and Performance Center, International Spine, 2070 Belmont Road, Washington, DC, 20009, USA, mehuljdesaimd@gmail.com.
Mehul J
MJ
Desai
Michael J
MJ
Ingraham
D059350:Chronic Pain / Q000191:economics / Q000503:physiopathology / Q000534:rehabilitation* / Q000628:therapy; D003131:Combined Modality Therapy / Q000191:economics; D020918:Complex Regional Pain Syndromes / Q000191:economics / Q000503:physiopathology / Q000534:rehabilitation* / Q000628:therapy; D003362:Cost-Benefit Analysis; D004599:Electric Stimulation Therapy / Q000191:economics; D004867:Equipment Design; D055111:Failed Back Surgery Syndrome / Q000191:economics / Q000503:physiopathology / Q000534:rehabilitation* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D010147:Pain Measurement; D017060:Patient Satisfaction; D026741:Physical Therapy Modalities / Q000191:economics; D019736:Prostheses and Implants / Q000191:economics; D011788:Quality of Life; D016896:Treatment Outcome