Experimental Spinal Cord Stimulation and Neuropathic Pain: Mechanism of Action, Technical Aspects, and Effectiveness

Helwin Smits, Maarten van Kleef, Jan Holsheimer, Elbert A. J. Joosten*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Spinal cord stimulation (SCS) is a valuable treatment for chronic intractable neuropathic pain. Although SCS has gone through a technological revolution over the last four decades, the neurophysiologic and biochemical mechanisms of action have only been partly elucidated. Animal experimental work has provided some evidence for spinal as well as supraspinal mechanisms of neuropathic pain relief of SCS. A SCS computer model of the electrical properties of the human spinal cord revealed many basic neurophysiologic principles that were clinically validated later on. The main question in clinical SCS is how to further improve the effectiveness of SCS as there is still a significant failure rate of 30%. In this context, experimental studies are needed to elucidate which target pain neuron(s) are involved, as well as with what exact electrical stimulation this target neuron can be influenced to produce an optimal supapression of neuropathic pain. This article reviews the basic clinical and experimental technical aspects in relation to the effectiveness of SCS in view of recent understanding of the dorsal horn pain circuit involved. These data may then result in experiments needed for an improved understanding of the mechanisms underlying SCS and consequently lead to improvement and increased effectiveness of SCS in neuropathic pain as a clinical therapy.
Original languageEnglish
Pages (from-to)154-168
JournalPain Practice
Issue number2
Publication statusPublished - Feb 2013


  • neuropathic pain
  • spinal cord stimulation
  • spinal cord
  • dorsal column
  • computer modeling
  • spine
  • spinal pain gate
  • review


Dive into the research topics of 'Experimental Spinal Cord Stimulation and Neuropathic Pain: Mechanism of Action, Technical Aspects, and Effectiveness'. Together they form a unique fingerprint.

Cite this