Long-term lived experiences of patients with chronic pain or angina pectoris treated with spinal cord stimulation: a qualitative study.

Abstract

To explore the short-term and long-term lived experiences of patients with chronic pain and angina pectoris with spinal cord stimulation. An interpretive qualitative study with thematic analysis of one-off, semistructured interviews, following Braun and Clarke (2006). A multidisciplinary, publicly funded pain service in Auckland, New Zealand. Patients usually undergo a comprehensive medical, psychological and functional assessment and an in-house pain management programme before proceeding to spinal cord stimulator implantation. Participants implanted with a spinal cord stimulator between 1998 and 2019 who had their stimulator for ≥1 year, purposively sampled to increase the range of ethnicities. The themes identified from the interviews. 24 participants with chronic pain of varied aetiology and a median (range) of 5.2 (2.4-23.2) years since stimulator implantation participated. 22 participants had the device in situ, and 2 had been explanted. Five main themes were identified: (1) embodiment: stimulator and body as one; (2) technical factors: batteries and type of stimulation; (3) improved well-being; (4) social connection and (5) healthcare system interaction. Most participants reported pain relief, but many had experienced complications and discomfort. They emphasised the importance of ongoing support from the pain service. Acceptance of pain, coping and embodiment emerged as common motifs across these themes. 21 participants were satisfied with their treatment. Within the context of a multidisciplinary pain clinic, despite some discomfort and various complications, most participants valued the ongoing reduction of pain achieved with spinal cord stimulation. Timely access to support from the pain service influenced their experience and satisfaction with their stimulators. Acceptance of pain and embodiment of the stimulator helped participants adapt to living with their stimulator, often over many years.