Chronic Pain

Prof. E.A. Joosten
Prof. M. van Kleef

Staff members:    
Dr. M. Sommer

A. Balthazar MSc.
M. van Beek MSc.
B. Brouwer MSc.
K. Meuwissen MSc.
R. Slangen MSc.

Focus of research:   
The understanding and application of neuromodulatory techniques, in particular spinal cord stimulation and pulsed radiofrequency, in order to minimize chronic (neuropathic) pain

Today Spinal Cord Stimulation (SCS) is used in the treatment of intractable neuropathic pain (NPP). Despite the existence of SCS as a pain therapy for over 40 years, up till now only two randomized clinical trials (RCT’s) have been performed: one in patients with CRPS-1(Chronic Regional Pain Syndrome) and the other one in patients with Failed Back Surgery Syndrome (FBSS), both of which provide limited clinical evidence that SCS relieves neuropathic pain. We extend implementation of SCS in other NPP syndromes and designed and completed a pilot study on the clinical effect of SCS in painful diabetic polyneuropathy (PDP).  As a follow-up, an RCT (Rachelle Slangen) on the effect of SCS in PDP is currently ongoing. In order to understand the underlying mechanism of action of SCS in PDP a rat model for PDP was developed in the laboratory and the effect of various stimulation parameters was analysed (thesis) . We now further test the role of SCS in small fiber neuropathies clinically (thesis Drs.B.Brouwer) in collaboration with Prof.Dr. C. Faber, Dr.I.Merkies (Department of Neurology).
From a basic scientific point of view the role of glial cells (as immune-regulatory cells) in the modulation of chronic pain (or plasticity of the nervous system) has our prime interest (projects Drs. M. van Beek; Drs.K.Meuwissen).
Pulsed Radiofrequency as a minimally invasive therapy for treatment of chronic lumbar radicular pain (low back pain) is being studied based on clinical studies (thesis Koen van Boxem/collaboration Dr.J.van Zundert (Genk, Belgium). In a rat model of lumbar radicular pain, the mechanism of action PRF is currently investigated (senior master project Glenn Franken).
Drs.A.Balthazar summarized the safety  shortcomings during interventional pain procedures (i.e.PRF) and now further analysis the aid and assistance of imaging techniques e.g.ultrasound and optical tools with special focus at the photonic needle.