The Use of Spinal Cord Stimulators for the Treatment of Abdominal Pain: A Comprehensive Review

Introduction: Abdominal pain is a challenging condition to treat due to its broad etiology, often refractory response to medical management, and often negative workup. Spinal cord stimulators (SCS) are a known gold standard for refractory chronic pain conditions, but their published use in the treatment of abdominal pain is relatively rare. Therefore, a literature search was undertaken from January 2000 through December 2022 and twenty-seven relevant articles were included in this review. Our goal was to provide a comprehensive review and source of information for interventional pain physicians on available literature regarding abdominal pain and the use of SCS for its treatment.
Objectives: The purpose of this article is to review the current use of spinal cord stimulators in the setting of abdominal pain and support its continued use.
Study design: This is a narrative review article with the goal of reviewing pertinent case reports, case series, prospective and retrospective studies, from January 2000 to December 2022 on the use of spinal cord stimulators in the treatment of abdominal pain.
Conclusion: Overall, the use of SCS resulted in decreased abdominal pain scores, relief of gastrointestinal symptoms, decreased morphine milligram equivalent requirements, and improved quality of life. These results support the initiation of randomized controlled trials in order to establish strong evidence for their use in the treatment of abdominal pain.

Keywords:Abdominal pain; spinal cord stimulator; neuromodulation; pain management; chronic pain

Key Points:a) Over two decades of articles were included in this review on the use of spinal cord stimulators for the treatment of abdominal pain.
b) The use of spinal cord stimulator was found to decrease abdominal pain scores in the patient population reviewed.
c) The use of spinal cord stimulator was found to decrease morphine milligram equivalent requirements in the patient population reviewed.
d) The use of spinal cord stimulator was also found to decrease gastrointestinal symptoms, such as nausea, vomiting, diarrhea, and constipation in the patient population reviewed.
e) The use of spinal cord stimulator was found to improve quality of life and daily functional ability in the patient population reviewed.
f) Given the lack of randomized control trials on the use of spinal cord stimulators for abdominal pain, the evidence for its use is considered insufficient, although can result in improvement.