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Canna~Fangled Abstracts

Dorsal Column Stimulation and Cannabinoids in the Treatment of Chronic Nociceptive and Neuropathic Pain: a Review of the Clinical and Pre-clinical Data

By February 8, 2022No Comments
Review
. 2022 Feb 4.

doi: 10.1007/s11916-022-01008-y.

Online ahead of print.
Charles A Odonkor 1, Tariq Alfara 2, Peju Adekoya 3, Vwaire Orhurhu 4, Tomás Rodríguez 5, Emily Sottosanti 6, Alan D Kaye 7
Affiliations 

Abstract

Purpose of review: The main objective of this review is to appraise the literature on the role of spinal cord stimulation (SCS), cannabinoid therapy, as well as SCS and cannabinoid combination therapy for the management of chronic neuropathic and nociceptive pain. Current research suggests that SCS reduces pain and increases functional status in carefully selected patients with minimal side effects.

Recent findings: As cannabinoid-based medications become a topic of increasing interest in pain management, data remains limited regarding the clinical efficacy of cannabinoids for pain relief. Furthermore, from a mechanistic perspective, although various pain treatment modalities utilize overlapping pain-signaling pathways, clarifying whether cannabinoids work synergistically with SCS via shared mechanisms remains to be determined. In considering secondary outcomes, the current literature suggests cannabinoids improve quality of life, specifically sleep quality, and that SCS decreases opioid consumption, increases functional capacity, and decreases long-term healthcare costs. These findings, along with the high safety profiles of SCS and cannabinoids overall, incentivize further exploration of cannabinoids as an adjunctive therapy to SCS in the treatment of neuropathic and nociceptive pain.

Keywords: CBD, Cannabinoids, Cannabis, Cord, Spinal, Stimulation

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
    1. •• Institute of Medicine (US) Committee on Advancing Pain Research, Care, and Education. Relieving pain in America: a blueprint for transforming prevention, care, education, and research. Washington (DC): National Academies Press (US). 2011. PMID: 22553896. Addresses the current state of pain research, care, and education; and provides recommendations intended to improve pain management approaches.
    1. •• Park PW, Dryer RD, Hegeman-Dingle R, Mardekian J, Zlateva G, Wolff GG, et al. Cost burden of chronic pain patients in a large integrated delivery system in the United States. Pain Pract [Internet]. 1 Nov 2016. 2019;16(8):1001–11. Available from: https://doi.org/10.1111/papr.12357 . Estimates healthcare costs and resource utilization among chronic pain patients. Results support using integrated delivery systems to evaluate ways to improve outcomes and lower healthcare costs for chronic pain patients.
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    1. •• Rice ASC, Smith BH, Blyth FM. Pain and the global burden of disease. Pain [Internet]. 2016 Apr [cited 2019 Jan 5];157(4):791–6. Available from: http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=0… . Article analyzing The Global Burden of Disease (GBD) Study of 2013, a comprehensive and extensive assessment of the global burden of chronic pain down to the country level over a 23-year time period.
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