Open AccessUnique aspects of clinical trials of invasive therapies for chronic pain
Author(s) -
Steven P. Cohen,
Mark Wallace,
Richard Rauck,
Brett R. Stacey
Publication year - 2019
Publication title -
pain reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.113
H-Index - 15
ISSN - 2471-2531
DOI - 10.1097/pr9.0000000000000687
Subject(s) - chronic pain , medicine , clinical trial , intensive care medicine , physical therapy , physical medicine and rehabilitation
Nearly all who review the literature conclude that the role of invasive procedures to treat chronic pain is poorly characterized because of the lack of “definitive” studies. The overt nature of invasive treatments, along with the risks, technical skills, and costs involved create challenges to study them. However, these challenges do not completely preclude evaluating invasive procedure effectiveness and safety using well-designed methods. This article reviews the challenges of studying outcomes of invasive therapies to treat pain and discuss possible solutions. Although the following discussion can apply to most invasive therapies to treat chronic pain, it is beyond the scope of the article to individually cover every invasive therapy used. Therefore, most of the examples focus on injection therapies to treat spine pain, spinal cord stimulation, and intrathecal drug therapies.