The following is a summary of “Neuropathic Pain Medication and Antidepressant Use after Disability Pension in Patients with Spinal Cord Stimulation for Persistent Spinal Pain Syndrome,” published in the January 2024 issue of Pain by Kaijankoski et al.
Managing persistent spinal pain syndrome (PSPS) presents significant challenges, often resulting in decreased work capacity due to the associated chronic pain.
Researchers conducted a retrospective study to investigate the impact of receiving a disability pension (DP) on pain levels and pain management strategies, focusing on neuropathic pain medication and antidepressant usage as markers of neuropathic pain in working-age patients with PSPS nearing retirement.
They analyzed data from 129 consecutive patients with PSPS who underwent spinal cord stimulation (SCS) device implantation at Kuopio University Hospital Neurosurgery (January 1, 1996- December 31, 2014). Purchased records of gabapentinoids, tricyclic antidepressants, and serotonin-norepinephrine reuptake inhibitors (January 1995- March 2016), along with information on employment status, were obtained from national registries.
The results showed that 28/129 (21.7%) SCS permanent patients experienced a DP, with 27 having sufficient follow-up time (two years before and one year after DP). During the follow-up, the majority of patients (61%) utilized neuropathic pain medications, while 44% used antidepressants. Many patients (70%, n = 19) retired due to dorsopathies. The dosage of gabapentinoids began to rise before the DP; post-DP, the doses showed a subsequent increase after initially decreasing, and remained at a lower level.
Investigators concluded that despite reduced medication use post-retirement, persistent chronic pain in pensioners after DP suggested the need for continued care resources, as evidenced by continued use of neuropathic pain medication and antidepressants.