Centralized pain features linked to weaker spinal cord stimulator trial response

A prospective study of 67 patients (51 completed follow-up) examined whether centralized/nociplastic pain features predict response to spinal cord stimulation (SCS) trials, using validated measures including the Central Sensitization Inventory, fibromyalgia criteria, and Brief Pain Inventory. The study reported that while pain severity and PROMIS domains improved significantly overall after SCS, patients achieving at least 50% reduction in worst pain had significantly lower fibromyalgianess scores, lower Central Sensitization Inventory scores, and less widespread pain than non-responders, despite no demographic differences between groups. The authors concluded that greater centralized pain burden was associated with reduced analgesic benefit from SCS, suggesting pre-procedural pain phenotyping may improve patient selection.

Most relevant for: Patients with chronic pain being considered for spinal cord stimulator trials, particularly those with features of central sensitization or fibromyalgia.

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