Efficacy of cranial electrotherapy stimulation for neuropathic pain following spinal cord injury: a multi-site randomized controlled trial with a secondary 6-month open-label phase

The Journal of Spinal Cord Medicine, 2011 · DOI: 10.1179/2045772311Y.0000000008 · Published: January 1, 2011

Spinal Cord Injury Pain Management Rehabilitation

Simple Explanation

This study investigates cranial electrotherapy stimulation (CES) for neuropathic pain after spinal cord injury (SCI). CES involves applying a small electrical current through the head using ear clips. Participants with SCI and chronic neuropathic pain were randomly assigned to receive either active CES or a sham treatment for one hour daily over 21 days. A six-month open-label phase followed. The study measured changes in pain ratings, pain interference, pain quality, pain beliefs, coping strategies, general health, depressive symptoms, stress, and anxiety before and after treatment.

Study Duration

21-day trial, 6-month open-label phase

Participants

105 adults with SCI and chronic neuropathic pain

Evidence Level

Level I: Multi-site, double-blind, sham-controlled study

Key Findings

1
The active CES group reported a significantly greater average decrease in pain during daily treatments compared to the sham group.
2
The active group showed larger pre- to post-treatment decreases in pain interference than the sham group did.
3
CES appears to have provided a small but statistically significant improvement in pain intensity and pain interference with few troublesome side effects.

Research Summary

This multi-site study evaluated the efficacy of cranial electrotherapy stimulation (CES) for neuropathic pain in individuals with spinal cord injury (SCI). The results indicated that active CES provided a small but statistically significant improvement in pain intensity and pain interference compared to sham CES. Although individual responses varied, CES appears to be a potentially beneficial treatment option for SCI-related neuropathic pain, with minimal side effects.

Practical Implications

Potential Treatment Option

CES may be considered as a potential treatment option for individuals with SCI and chronic neuropathic pain, especially when other treatments have been ineffective.

Personalized Approach

Given the variability in treatment response, it is important to identify personal and pain characteristics that predict the effectiveness of CES.

Complementary Therapy

CES could be used as a complementary therapy alongside other pain management strategies to achieve more manageable pain levels.

Study Limitations

1
Baseline differences existed between the active and sham groups on several outcome measures, making group comparisons challenging.
2
There was a high attrition rate by the end of the 6-month phase, limiting the evaluation of long-term efficacy.
3
All outcome measures were obtained through self-report, lacking objective measures of function.

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