Over the past two decades, SCS has demonstrated effectiveness in treatment of diverse chronic intractable pain disorders. However, majority of published SCS literature is limited to pain conditions most frequently seen in medical practice with very limited information regarding use of SCS for less common conditions. The following case report is based on retrospective chart review of a patient who developed thalamic pain syndrome in the upper extremity, and was subsequently implanted with the Precision™ SCS system.

A 48-year old male with a history of stroke, had physical therapy for thalamic pain syndrome and upper extremity weakness, during which he sustained an injury to the right shoulder. He presented with persistent pain associated with movement of the right arm and hand (VAS rating of 9 on a 10 point scale). Previous treatments included opioids, antiepileptics, physical therapy, and nerve blocks. Since these treatments provided only temporary and inadequate pain relief, the patient was no longer able to continue physical therapy. He was successfully trialed and subsequently implanted with a single lead having 8 independent current-controlled contacts (Advanced Bionics Corporation) at C4.

Upon activation of the device, he reported immediate and significant pain relief with coverage from the right shoulder to the hand. Since the affected limb was his dominant hand, he was able to resume activities of daily living without assistance and continue physical therapy once he was pain-free as a result of SCS treatment. Six months after the implant procedure, he reported continued pain relief and improvement in qualify of life.

When evaluating treatment options for pain for less common conditions, SCS may receive less consideration than justified, given its potential benefits. The utility of SCS in many pain conditions has been well established; hence this consideration should extend to the treatment of infrequent pain conditions of neuropathic origins.