What’s Going On
By Ted Swing, Ph.D.
Advances in the treatment of chronic pain depend on clinical trials that test the latest medications, procedures and medical devices. As part of our commitment to leading the way in the field of pain management, we at Arizona Pain are conducting multiple clinical trials. These trials involve patients receiving some type of treatment for a chronic pain condition, typically a study treatment and some type of placebo or other comparison group, and then following up with those patients for a period of months or years.
Pfizer Lyrica Study
Pregabalin, more commonly known as Lyrica, is an approved medication that has proven safe and effective for treating certain types of nerve pain, such as diabetic peripheral neuropathy. Another form of nerve pain is post-traumatic peripheral nerve pain. This form of pain results from physical trauma, such as falls, burns, motor vehicle accidents, or even as a result of surgery. In this case, the trauma may cause permanent damage to a specific branch of peripheral nerves (nerves found throughout the body, rather than those of the spine and brain). Even after other tissues have healed, post-traumatic pain in that peripheral nerve may continue. We are taking part in a study of the efficacy of Lyrica for post-traumatic peripheral nerve pain. Patients taking part in this study will receive Lyrica or placebo for 17 weeks.
Seikagaku Herniated Disc Study
One common cause of pain in the back and legs is herniation of a disc in the lumbar spine. When the disc herniates, or bulges outward, it can put pressure on the spinal cord or nerve roots causing back pain that may radiate into one or both legs. In many cases, such disc herniations go away with conservative care, such as rest, chiropractic care or physical therapy. Medications and epidural steroid injections also provide many patients with relief for this condition. However, for patients who do not get relief from these treatments, one of the only remaining options has traditionally been surgery.
We are taking part in a study of a new treatment that may change that. This study is evaluating a drug that can be injected into a herniated disc and will cause the herniation to shrink inward, relieving pressure on the spinal cord. This could permanently relieve pain without requiring surgery. Of patients enrolling in this study, 75 percent receive an injection of this study drug, while 25% percent receive a placebo injection. Patients are then followed up for two years.
St. Jude SENSE Study
Patients whose pain is not relieved by conservative care, medications and appropriate interventional treatments may be candidates for a medical device called a spinal cord stimulator (SCS). These devices are implanted along the spinal cord and deliver mild electrical pulses through leads. The leads are positioned so that the electrical stimulation affects the nerves transmitting that patient’s pain. The stimulation replaces the pain with a mild tingling feeling. Spinal cord stimulators have been used successfully for years, however some types of pain are harder to relieve with SCS.
We are taking part in a study with St. Jude in which we compare traditional SCS with a new type of system that delivers both spinal cord stimulation (SCS) as well as peripheral nerve field stimulation (PNfS). Patients who are candidates for SCS due to low back and leg pain and have not received adequate relief from other treatments, including back surgery, may be candidates for this trial. Those enrolled will receive either the current SCS system or the SCS/PNfS combination system and will be followed up for up to two years.
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