{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T18:24:54Z","timestamp":1785176694963,"version":"3.55.0"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T00:00:00Z","timestamp":1753142400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pain Res."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Chronic pain affects a significant portion of the population, and conventional treatments often prove insufficient. Spinal Cord Stimulation (SCS), a neuromodulation technique, has shown benefits in pain relief, while physiotherapy is widely employed to enhance physical function and quality of life. Although the combination of these approaches may offer synergistic effects, existing evidence is limited and fragmented.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>This systematic review aimed to evaluate the clinical outcomes of Spinal Cord Stimulation (SCS), with or without the association of physiotherapy, in the management of chronic pain in adults. Methodology: The review was conducted following PRISMA guidelines and the PICO strategy. A comprehensive search was performed across databases including Cochrane Library, ScienceDirect, BASE, and VHL (BVS: MEDLINE, IBECS, WPRIM, LILACS, PERI\u00d3DICO CAPES) using MeSH terms and Boolean operators: (\u201cSpinal Cord Stimulation\u201d OR \u201cNeuromodulation\u201d) AND (\u201cChronic Pain\u201d OR \u201cPain Management\u201d) AND (\u201cPhysical Therapy Modalities\u201d OR \u201cPhysiotherapy\u201d OR \u201cRehabilitation\u201d). Only studies published in English, Spanish, or Portuguese in the past 10 years were included, focusing on chronic pain and reporting outcomes related to pain reduction and functional improvement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eight studies comprising 777 patients were included. Spinal cord stimulation alone led to significant pain reductions, with responder rates above 80% and average decreases of 5\u20136\u2005cm on pain scales. Improvements in quality of life and functional disability were also reported, with reductions of over 30 points in disability indices and up to 40% in opioid use. However, only one study included physiotherapy as a complementary intervention, without isolating its effects. No study directly evaluated the combined efficacy of SCS and physiotherapy, highlighting a gap in the literature.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The findings highlight the proven effectiveness of SCS in chronic pain management but reveal a lack of studies assessing its integration with physiotherapy. Future clinical trials should address this gap to explore potential synergistic effects and optimize interdisciplinary pain treatment strategies.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpain.2025.1620289","type":"journal-article","created":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T05:30:04Z","timestamp":1753162204000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["The effectiveness of spinal cord stimulation combined with physiotherapy in the management of chronic pain in adults: a systematic review"],"prefix":"10.3389","volume":"6","author":[{"given":"Adilia Maria Soares Porciuncula","family":"Barros","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabrielly Santos","family":"Pereira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josie Resende Torres da","family":"Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo Louren\u00e7o da","family":"Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria do Desterro da","family":"Costa e Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciano Maia Alves","family":"Ferrera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2092","DOI":"10.1097\/j.pain.0000000000001009","article-title":"Defining chronic pain in epidemiological studies: a systematic review and meta-analysis","volume":"158","author":"Steingr\u00edmsd\u00f3ttir","year":"2017","journal-title":"Pain"},{"key":"B2","doi-asserted-by":"publisher","first-page":"770","DOI":"10.1186\/1471-2458-11-770","article-title":"Pain as a global public health priority","volume":"11","author":"Goldberg","year":"2011","journal-title":"BMC Public Health"},{"key":"B3","doi-asserted-by":"publisher","first-page":"E199","DOI":"10.36076\/ppj.2012\/15\/E199","article-title":"Effectiveness of therapeutic lumbar transforaminal epidural steroid injections in managing lumbar spinal pain","volume":"15","author":"Manchikanti","year":"2012","journal-title":"Pain Physician"},{"key":"B4","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1016\/j.pain.2007.07.028","article-title":"Spinal cord stimulation versus conventional medical management for neuropathic pain: a multicentre randomised controlled trial in patients with failed back surgery syndrome","volume":"132","author":"Kumar","year":"2007","journal-title":"Pain"},{"key":"B5","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1111\/ner.12206","article-title":"The appropriate use of neurostimulation: avoidance and treatment of complications of neurostimulation therapies for the treatment of chronic pain. 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