A case of back pain caused by bilateral polynephrolithiasis successfully treated with spinal cord stimulation therapy

Abstract

A 47-year-old man with bilateral multiple nephrolithiasis had been suffering from chronic back pain due to residual stones despite periodic transurethral ureterolithotripsy. Even under prescription opioids, he had dull pain in his back with numerical rating scale (NRS) 7 when resting, and sharp pain with NRS 8 when moving or putting pressure on his back. He was unable to work or sleep. Three days following an epidural block, his resting pain reduced to NRS 3, and we implanted the spinal cord stimulation (SCS). With SCS stimulation, his back pain at rest and back tenderness were reduced to NRS 1 and NRS 2, respectively. After that, he no longer needed opioids and returned to work or sleep. Both resting pain and incident pain were visceral with somatic, but SCS was significantly effective for both nociceptive types of pain. SCS may be a good indication for chronic pain caused by polynephrolithiasis. It can avoid long-term opioid use and improve ADL and QOL.