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

  • Regenerative Pain Medicine/Interventional Pain Medicine (EC Bradley, Section Editors)
  • Published:
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A Correction to this article was published on 15 February 2022

This article has been updated

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.

Summary

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.

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Authors and Affiliations

  1. Department of Orthopaedics and Rehabilitation, Division of Physiatry, Interventional Pain Medicine, Yale University School of Medicine, New Haven, CT, USA

    Charles A. Odonkor

  2. Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Tariq AlFarra

  3. Department of Anesthesia and Critical Care, Division of Pain Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Peju Adekoya

  4. Department of Anesthesia, Critical Care and Pain Medicine, Division of Pain, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Vwaire Orhurhu

  5. Therapeutics Institute, University of Massachusetts Medical School, MA, Worcester, USA

    Tomás Rodríguez

  6. Department of Anesthesiology, Beth Israel Deaconess Medical Center, Critical Care and Pain, Harvard Medical School, Boston, MA, USA

    Emily Sottosanti

  7. Department of Anesthesiology, Louisiana State University Health Sciences Center, Shreveport, LA, USA

    Alan D. Kaye

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Odonkor, C.A., AlFarra, T., Adekoya, P. et al. Dorsal Column Stimulation and Cannabinoids in the Treatment of Chronic Nociceptive and Neuropathic Pain: a Review of the Clinical and Pre-clinical Data. Curr Pain Headache Rep 26, 103–118 (2022). https://doi.org/10.1007/s11916-022-01008-y

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