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Rehabilitation of the spinal cord (SCS) for chronic pain involves bringing low levels of electricity directly into the spinal cord using a device that is inserted, modifying, or blocking nerve function to reduce pain reaching the brain. The method is often used after the non-surgical pain treatment options have failed to provide adequate relief.

The basic principles of how SCS works are not fully understood, but in a new paper published on April 28, 2022, in the online journal of the journal Bioelectronic Medicine, a team of researchers led by scientists. High-frequency SCS was found to be more effective in improving visual pain reduction (PPR) than low-frequency SCS SCS in the study patients, and there were some differences in PPR between male and female patients.

Low-frequency SCS (50 Hz) was first approved by the U.S. Food and Drug Administration (FDA) as a treatment for chronic back and leg pain in 1989. In 2015, the FDA approved high-dose SCS (10,000 Hz), which transmits short-term electric stimulation pulses, is low in amplitude and does not cause paresthesia, a rare sensation of biting or stinging.

A recently published retrospective study examined 237 patients who received SCS treatment between 2004 and 2020: 94 patients (40 women, 54 men) who received HF-SCS and 143 patients (70 women and 73 men) who received LF-SCS. Three to six months after transplantation, the researchers found that PPR in all patients improved compared to baseline, but HF-SCS produced more PPR than LF-SCS. HF-SCS was also associated with the subsequent use of opioids to relieve pain.

However, there were differences between both:

• Male PPR, for example, was significantly better at HF-SCS at 3 and 6 months compared to LF-SCS, while this was only true for women at 6 months.

• LF-SCS males used multiple opioids after implantation and at six months of age while females used most opioids after implantation, they were three, six and usually used multiple opiates over a 12-month period.

The work was inspired by a growing body of literature on sexually explicit contraceptives, “said senior author Imanuel Lerman, MD, associate professor of anesthesiology, and pain management specialist at UC San Diego Health, and the Qualcomm Institute. The marked difference in the parameter (high frequency compared to low frequency) based on gender in spinal mobility efficiency and opiate use is astonishing.