UK specialist nurses are helping pioneer a new electrical treatment for long-term pain.
A surgically implanted device that electrically stimulates the nerves can significantly reduce pain levels in patients with long-term pain, according to preliminary study results revealed to Nursing Times.
Between July and December 2008, specialist pain management nurses at eight acute trusts in England led trials of the technique – known as neuromodulation – on patients with long-term, non-malignant pain.
Neuromodulation – which was recommended in NICE guidance on spinal cord compression in October last year – works by surgically implanting a neurostimulator under the skin of the patient’s abdomen.
This then generates an electrical pulse which is fed through a wire to an electrode implanted near the spinal cord, or the epidural space closest to the patient’s pain site. The patient then uses a remote control to turn the neurotransmitter on or off, and to adjust the level of stimulation to relieve pain.
Results from an audit of all eight hospitals in the trial, including Liverpool Royal University Hospital and the James Cook University Hospital in Middlesborough, showed the device had a significant impact on reducing patients’ pain, and improving their quality of life.
Of the 99 patients involved in the trials, just under half said the device provided 50% or more pain relief for the pain it was intended to treat, and 16% said it provided total pain relief.
Over 64% also said that their walking had improved following the use of the neuromodulation device, 56% said it had improved their ability to stand and over half said their ability to wash and dress themselves had improved.
Additionally, more than a third said the device had improved their ability to work, and 70% said their mood had improved as a result of the stimulator.
Although a surgeon is responsible for implanting the neuromodulation device, care before and after the procedure is predominantly nurse-led. Pain nurse specialists provide comprehensive information and advice prior to the procedure, and are responsible for the patient’s follow-up care.
This usually involves checking the device after a week, then at three and six months. If there are no problems, the patient only has to be seen once a year for a check-up.
However, the nurses also run a telephone advice line that patients can call with any questions.
Heather Williams, nurse consultant in chronic pain management at Newcastle’s Royal Victoria Infirmary, who led the trial at her hospital, admitted that the technique was an ‘expensive and invasive treatment’ but said the impact of long-term pain on a patient’s life should not be underestimated.
‘Although it is not life threatening, chronic pain affects all areas of a person’s life and can be life changing,’ she told Nursing Times.