Effect of Spinal Cord Stimulation on Skin Temperature in Patients with Neuropathic Pain: An Observational Study.

Background: Spinal cord stimulation (SCS) can successfully treat neuropathic pain when conventional medication fails. Current evaluation methods, however, are primarily subjective. This study explored the use of infrared thermography as an objective method to detect physiological effects of SCS. Methods: This prospective observational study included 25 patients treated with SCS for neuropathic pain. Skin temperature was measured using infrared thermography before and during the first 60 minutes of stimulation. Pain intensity was assessed using an 11-point Numerical Rating Scale (NRS). The primary hypothesis was that SCS would lead to a significant skin temperature increase of at least 1°C. Results: Mean skin temperature in the affected area increased significantly from 29.1 ± 2.3°C to 30.8 ± 1.8°C (p = 0.0002). On the contralateral side, it increased from 29.3 ± 2.2°C to 30.0 ± 1.8°C (p = 0.0037). Temperature responses varied among individuals. A post hoc analysis showed that patients with a temperature increase of ≥1°C (responders) demonstrated significantly greater long-term improvement in pain chronification scores compared to non-responders (p = 0.002). Conclusion: SCS produces measurable increases in skin temperature in patients with neuropathic pain. A ≥1°C temperature increase may indicate favorable long-term response. Infrared thermography may serve as a valuable objective measure for evaluating SCS efficacy.