REVIEW ARTICLE Clinical Applications of Neurostimulation: Forty Years Later

TL;DR: A growing body of literature supports neurostimulation for visceral pain in general and interstitial cystitis in particular and a basic principle, patient selection for the appropriate neurostimulated modalities is essential for safe, efficacious, and cost- effective applications of this therapy.

Abstract: With the recent technological advances, neu- rostimulation has provided new hope for millions of patients with debilitating chronic pain conditions that respond poorly to other therapies. Outcome research demonstrated that patients with failed back surgery syndrome and complex regional pain syndromes benefit significantly from neuro- stimulation in pain reduction, functional capacity, and quality of life. Increasing clinical evidence supports the use of neurostimulation in post-herpetic neuralgia, peripheral neuropathy, occipital neuralgia, and other neuropathic pain conditions. Strong clinical evidences indicate that neurostimulation offers less invasive and more effective therapies for many patients with ischemic pain caused by cardiovascular and peripheral vascular diseases. A growing body of literature supports neurostimulation for visceral pain in general and interstitial cystitis in particular. As a basic principle, patient selection for the appropriate neurostimu- lation modalities is essential for safe, efficacious, and cost- effective applications of this therapy. Research with more vigorous designs is needed to establish evidence-based appli- cations of neuromodulation therapy in emerging indications of pain management.