Vorenkamp Kevin E, Lee Gemayel, Lester Denise D, Konda Chaitanya, Cohen Steven P, Crosby Nate D, Boggs Joseph W
Department of Anesthesiology, Duke University Health System, 4314 Orange Zone, Durham, NC, 27710, USA.
Relive You Center for Advanced Pain Management, San Diego, USA.
Pain Ther. 2025 May 26. doi: 10.1007/s40122-025-00746-2.
Shoulder pain can be a chronic, disabling condition resulting in major procedures like surgery that are invasive, costly, and pose significant risks to patients. Minimally invasive interventions that provide durable relief can improve outcomes while enabling patients to avoid accruing additional healthcare costs. The present survey study evaluated durability of pain relief in a real-world shoulder pain population following percutaneous 60-day peripheral nerve stimulation (PNS) treatment.
A cross-sectional follow-up survey assessed follow-up outcomes among patients who received 60-day PNS for chronic shoulder pain. Outcomes included patient-reported percent pain relief, average and worst pain scores, and patient impression of change in quality of life, physical function, and sleep. Patients also reported other treatments and interventions used for their shoulder pain since the 60-day PNS treatment including changes in medication usage.
Among 489 survey participants (mean follow-up 21 months, range 6-60), 83% (405/489) reported no subsequent radiofrequency ablation, permanent implant, or surgery following 60-day PNS. Within this subset, 87% reported ongoing improvement in at least one domain at follow-up, including 71% who maintained ≥ 50% pain relief, and more than half who reported much or very much improved quality of life (61%), physical function (57%), or sleep (57%). Among those using PNS seeking to avoid surgery (n = 265), 81% reported no subsequent surgery, with 77% of those patients maintaining ≥ 50% pain relief. Outcomes were consistent across follow-up durations and shoulder pain etiologies.
This real-world evidence demonstrates that a large majority of responders to 60-day PNS may experience durable shoulder pain relief and other improvements, with benefits demonstrated up to 5 years post treatment. The low rate of progression to subsequent interventions including surgery suggests potential for healthcare economic benefit, supporting 60-day PNS as both a clinically effective and potentially economically advantageous approach for appropriate patients.
肩部疼痛可能是一种慢性致残病症，会导致诸如手术等重大治疗手段，这些手术具有侵入性、成本高昂且给患者带来重大风险。能提供持久缓解效果的微创干预措施可改善治疗结果，同时使患者避免产生额外的医疗费用。本调查研究评估了经皮60天周围神经刺激（PNS）治疗后，现实世界中肩部疼痛人群疼痛缓解的持久性。
一项横断面随访调查评估了接受60天PNS治疗慢性肩部疼痛患者的随访结果。结果包括患者报告的疼痛缓解百分比、平均和最严重疼痛评分，以及患者对生活质量、身体功能和睡眠变化的印象。患者还报告了自60天PNS治疗以来用于肩部疼痛的其他治疗和干预措施，包括药物使用的变化。
在489名调查参与者中（平均随访21个月，范围6 - 60个月），83%（405/489）报告在60天PNS治疗后未进行后续的射频消融、永久性植入或手术。在这个子集中，87%报告在随访时至少有一个领域持续改善，其中71%维持了≥50%的疼痛缓解，超过一半的人报告生活质量（61%）、身体功能（57%）或睡眠（57%）有很大或非常大的改善。在那些使用PNS试图避免手术的患者中（n = 265），81%报告未进行后续手术，其中77%的患者维持了≥50%的疼痛缓解。随访时间和肩部疼痛病因的结果一致。
这一现实世界证据表明，60天PNS治疗的大多数应答者可能会经历持久的肩部疼痛缓解和其他改善，治疗后长达5年都有获益。进展到包括手术在内的后续干预的低发生率表明具有医疗经济效益潜力，支持60天PNS作为一种对合适患者既临床有效又可能具有经济优势的方法。
