Editor-in-Chief: Alaa Abd-Elsayed, MD
Abstract
- 2026;10;711-714 Successful Reduction of Excessive Polypharmacy in Chronic Neuropathic Pain Using Spinal Cord Stimulation and Exercise Therapy: A Case Report
Case Report
Azusa Mori, MD, PhD, Yuki Nomura, MD, PhD, Hitoaki Sato, MD, PhD, Kyohei Ueno, MD, PhD, Yuki Nishiahara, MD, PhD, Takuya Okada, MD, PhD, and Norihiko Obata, MD.
BACKGROUND: Chronic pain is frequently associated with polypharmacy, increasing the risk of adverse events and poor adherence.
CASE REPORT: We report a 50-year-old woman with refractory neuropathic pain following cellulitis, complicated by extensive polypharmacy (24 medications) and multiple adverse effects. An inpatient spinal cord stimulation (SCS) trial combined with structured walking exercise rapidly reduced pain intensity (Numeric Rating Scale: 7 to 1), enabling systematic deprescribing. Permanent implantation was not performed, as pain control was maintained after lead removal. At discharge, medications were reduced to 9, with sustained improvement over 9 months.
CONCLUSIONS: Our case suggests that short-term SCS may serve as a bridge therapy to facilitate deprescribing and functional recovery in patients with complex chronic pain and polypharmacy.
KEYWORDS: Chronic pain, case report, polypharmacy, shared decision-making, spinal cord stimulation