New trial could transform treatment for chronic pain sufferers

A pioneering new study that could transform the way chronic pain is treated is underway at Guy’s and St Thomas’, in partnership with King’s College London.

The trial has already brought relief to Sean Homer, from Guernsey, who has suffered from back pain for more than three decades, leaving him unable to work and severely affecting his mobility.

After receiving an implant of spinal cord stimulation as part of the CSF-STIM trial, Sean is looking forward to getting his life back on track while helping to improve the care for other back pain sufferers.

Spinal cord stimulation is an alternative to major back surgery and works by delivering small electrical currents to the spinal cord, which disrupt pain signals to the brain. The treatment is delivered through leads connected to a matchbox-sized battery-powered generator, with both implanted under the skin near the lower back during a minor surgical procedure.

Back pain has been an almost constant fixture in Sean’s life since his early 20s. After injuring himself while making home improvements, Sean underwent his first back surgery in 1986. He then had to undergo another surgery in 2013 after rupturing a disc.

The 55-year-old said: “I woke up one morning and I was in the most excruciating pain. I knew something was seriously wrong. I could barely get out of bed and get myself into the shower.”

Though the operation was successful, five years later Sean damaged his back again at work.

Sean, who worked as a technician for a concert hall, added: “It is just the most awful pain to have. The only time I wasn’t in pain was when I was lying flat on the floor. To get myself dressed on a morning it could take more than 45 minutes. It stopped me from working and I’ve had to walk with the use of a crutch.”

In late 2019, Sean was referred to Guy’s and St Thomas’ where he became one of the first patients to be recruited to the CSF-STIM trial.

The purpose of the study is to identify the correlation between pain treatment and the biological content of cerebrospinal fluid (CSF), which is the fluid that surrounds the brain and the spinal cord. Patients are fitted with a spinal cord stimulator, which in some patients can provide relief from forms of back pain.

Patients on the study have a sample of their CSF taken before and after the spinal cord stimulator is fitted. The samples are studied by King’s College London to see if any molecular changes occur once a patient is undergoing treatment. This will help researchers to better understand chronic pain conditions and help to assess which treatments will be the most effective.

The relief for Sean was almost instant. He said: “After the spinal cord stimulator device was fitted and programmed in a matter of hours, I was surprised to be told that I could leave.

“Straight away I was in less pain and my mobility was better. After I left the hospital I turned to my wife Lynne and said: ‘I don’t need to walk with the crutch anymore’.”

Due to the injuries he has sustained, Sean will never be cured completely, however since undergoing his treatment, his pain is greatly reduced and his mobility is better than it has been in years. Sean is now able to go swimming for the first time in a number of years and is currently looking for work.

Sean said: “I can’t describe the difference this has made. I feel like I’ve got my life back. I really can’t thank the pain management team at Guy’s and St Thomas’ enough. They’ve transformed my life.

“Aside from being fitted with the device, they also taught me so much about the psychological aspects of pain and how you can retrain the way that you think about it, or find different ways to manage the pain you’re in.”

To thank staff who helped him, Sean has raised funds for the pain research and development department at St Thomas’ Hospital. Three years ago Sean made a pact not to cut his hair until he’d got his back pain into a manageable state and so celebrated his successful treatment by shaving all of his hair off. 

Sean’s local community got behind him and he has so far raised more than £1,500 for Guy’s and St Thomas’ Charity. He also donated his hair to the Little Princess Trust, who provide real hair wigs to children and young people who have lost their hair through cancer treatment and other conditions.

Sean said: “It was a really fantastic day. Everyone says my new look really suits me so I think I might leave it like this.”

Getting involved in the CSF-STIM trial is another way that Sean has shown his appreciation for the work that is done by the pain management team. He said: “If taking part in this study can stop just one person from going through what I’ve gone through, then it’s all been worth it.”

The study launched in August 2019 and is currently running, having been put on pause due to coronavirus.

Dr Adnan Al-kaisy, Principle Investigator of CSF-STIM and clinical lead of the pain management department at St Thomas’ Hospital, said: “It’s incredible to see the difference that the spinal cord stimulation has made to Sean’s life and we thank him for choosing to raise money to help fund further research in our department.

“It means a great deal to us when patients take such an active role in their healthcare, while helping to shape future treatments for others.

“The vision for the CSF-STIM study is to discover biomarkers that will enable us to pinpoint precisely who, like Sean, will respond to spinal cord stimulation positively, before the device is fitted. This will help us to find the most effective treatments for future patients and avoid unnecessary irreversible surgery.”