Just over one year ago, the SPRINT PNS System received an expanded indication enabling the on-label treatment of chronic head and neck pain. Board-certified anesthesiologist, interventional pain specialist and SPR consultant Dr. Samir Sheth shares how he got started with the SPRINT PNS System and his experiences with PNS of the occipital and cervical medial branch nerves.
What were your early experiences with the SPRINT PNS System?
Early on, I had been really interested in neuromodulation, and a little less so with peripheral nerve stimulation. Then about three years ago, a 35-year-old patient with multiple sclerosis and chronic low back pain came into my office. I just didn’t feel comfortable doing a radiofrequency ablation (RFA) of her lumbar spine. Because the SPRINT PNS System is low risk, I thought it made sense to try.
The patient did really well with the treatment. Since then, I’ve done around 200 SPRINT PNS cases on everything from shoulders and back to knees. It became something I consider very early in my treatment algorithm. In my experience, SPRINT PNS is a non-destructive and low-risk, potentially high-reward option for many patients.
What makes the SPRINT PNS System appealing for the treatment of head and neck pain?
Head and neck pain can be debilitating—many of my patients have a severely impacted quality of life. It can be so difficult to treat. Many are affected by the pain in their sleep, in their work, in their day-to-day routines. So, if they can experience even a little bit of relief, it’s a really a big deal.
Prior to SPRINT PNS, I had success using traditional spinal cord stimulation (SCS) systems to stimulate the occipital nerve, but I couldn’t always get approval or authorization for those cases. In addition, my experience with SCS systems targeting the occipital nerve is that they were tedious and had issues with lead migration and lead erosion. I was also doing nerve blocks and RFA. Now, I prefer to present SPRINT PNS earlier in my care continuum, before SCS and RFA, as the risks are low, and the benefits can be significant. If I can potentially get sustained pain relief with a non-destructive device like SPRINT PNS, why wouldn’t I consider that first? Obtaining sustained pain relief with a non-destructive device like SPRINT PNS provides clinicians with a new powerful option for our patients.
Tell us about your experience using SPRINT PNS in chronic head and neck pain.
So far, I've done 15-20 of these cases, and I’ve been very impressed with the amount of relief patients are experiencing. Many of my patients with occipital nerve stimulation have done so well—describing significant pain relief, and their medication use is down to almost zero. For me, that’s a significant win that we often do not discuss, because of the potential impact of chronic use of NSAIDs and migraine medications on their bodies.
At what point would you recommend considering the use of the SPRINT PNS System for patients who experience chronic pain in the head and neck area?
For many of my patients, this is one of the first options I like to discuss with them. I like presenting a minimally-invasive treatment like the SPRINT PNS System over RFA for my patients. It’s important to let patients know that they have a non-destructive, non-permanent, non-surgical treatment option.
With serious adverse events being rare and infections occurring less than 1% of the time, the safety profile is another reason I like to present this option. The most common adverse event is skin irritation from the adhesive components, with other less-reported events including itching at the electrode exit site, granuloma, and pain after electrode placement.
Ultimately, in patients who have significant pain in the back of their head or neck, there are very few reasons not to consider the SPRINT PNS System early in the care continuum—I've been very impressed with the relief I’ve seen so far, and I am very excited to have treatment opportunities to increase therapy awareness for this debilitating condition.