Practice Parameters for the Use of Spinal Cord Stimulation in the Treatment of Chronic Neuropathic Pain

Postural Changes

How should postural changes in paresthesia be managed?

Changes in paresthesia intensity and/or location corresponding to the patient's changes in posture are normal.  Information about this phenomenon should be stressed during patient education and can be demonstrated within hours of placement of a temporary electrode.  Most patients comment on postural changes and adjust quickly; some complain short-term, but patients rarely mention the phenomenon at long-term follow-up.  Some patients appreciate their ability to control stimulation amplitude with simple postural changes; new SCS systems with multiple program options might help the few who regard this as a problem to avoid the phenomenon.

Strength of recommendation Evidence source(s)/rationale
N/A -- information only N/A -- see Bibliography for relevant literature