A Pre- and Post-Implantable Pain Device Procedure Assessment Model: Psychiatric Symptoms, Functioning, and Goals

Abstract

Aim: Implantable device treatment may improve psychosocial and pain-specific outcomes. This paper reports outcomes following receipt of an implantable pain device in a population of military veterans. Materials/methods: 120 veterans completed a pre-implantable pain device psychological evaluation of mood, anxiety, pain disability and intensity, cognition, functional goals, walking tolerance, substance use and sleep. Of those evaluated, 25/120 (20.8%) received a pain device in the 12 months following their evaluation and repeated the evaluation to assess changes. Results: Veterans receiving pain devices endorsed significant improvements in pain intensity and pain disability. Pre-to-post-implant changes on psychosocial characteristics varied substantially. Conclusion: Veterans evaluated for implantable pain devices frequently endorsed symptoms of psychological distress and functional impairment and showed highly varied psychosocial changes with treatment.

Plain language summary

Spinal column stimulation (SCS) is a treatment for chronic pain involving the surgical placement of a medical device used to reduce pain symptoms. Although SCS is known to reduce pain intensity, recent research suggests that SCS may also improve physical function, quality of life and perhaps even mental health. This study tested the potential for broader benefits of SCS among 120 US military veterans. Each veteran completed a set of measures during their spinal column stimulation treatment process about pain, function, quality of life, mental health and treatment goals. Those obtaining an SCS were contacted up to a year later to retake the measures to identify improvements they experienced. Before SCS treatment, veterans often reported problems with pain, disability, sleep, quality of life and mental health. Furthermore, among those veterans who completed their follow-up visit, many reported improvements in these areas.

Keywords::

• chronic pain
• mental health
• psychological assessment
• spinal column stimulation
• veterans

Author contributions

M Garcia – conceptualization, data collection, writing, and analyses. A Emami – data collection, writing, and analyses. L Blau – data collection, writing, analyses, and tables. T Rutledge – data collection, conceptualization, guidance on analyses and writing.

Acknowledgments

We would like to acknowledge the pain clinic physicians who worked to screen and refer patients to psychology, without whom this research would not be possible.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.