Implantable technology for pain management

Chronic pain has now been recognized as a disease entity in its own right. Significant numbers of patients suffer from intractable chronic pain. Neuromodulation has been defined by the International Neuromodulation Society as ‘the therapeutic alteration of activity in the central or peripheral nervous system either electrically or pharmacologically’. It can be achieved either by electrical stimulation of peripheral nerves, spinal cord or brain, or by delivering pharmacological agents directly into the intrathecal, epidural or intracerebroventricular sites. Neuromodulation is expensive, invasive and not without complications. Patients requiring neuromodulation should undergo multidisciplinary assessment for suitability. Clinical effectiveness is possible with appropriate patient selection and attention to technical details.