Return to work after neurostimulation for chronic pain: a systematic review and meta-analysis

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ID: 318172
2026
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Ranked #53 of 56 articles by views in regional anesthesia and pain medicine

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Abstract
Abstract Objective Chronic pain patients experience more work disability leading to unemployment and major individual, societal and economic burden. Implanted neurostimulation has proven good results in terms of pain relief for chronic pain patients. As new stimulation techniques, paradigms and targets are being researched, a comprehensive synthesis of the effects of implanted neurostimulation on occupational outcomes remains undetermined. Methods MEDLINE (via PubMed), Embase, Scopus & Web of Science were systematically searched. Risk-of-bias was assessed using the modified Downs & Black checklist. Random-effects meta-analyses, including a Bayesian approach, were conducted to provide estimates of work status and return to work rates. The study protocol was prospectively registered on PROSPERO (CRD42024501152). Results 67 studies were identified for inclusion in the review; 56 were included in the meta-analysis. The paired odds to work following neurostimulator implantation increased significantly (OR 5.17; 95%CI 2.89–9.23; I2=49.0%; n = 56; P < 0.0001) and were confirmed in the conservative random-effects (OR 3.39; 95%CI 2.00–5.75; n = 56; P < 0.0001) and Bayesian model with uniform prior (OR 5.68; 95%CI 3.08–11.79; n = 56). The pooled estimate for the proportion of patients returning to work across neurostimulation modalities was 26.05% (95%CI 20.73%–32.18%; I2=68.9%; n = 55). Conclusions Implanted electrical neurostimulation is associated with increased paired odds to work and enabled chronic pain patients to return to work. The best effects were achieved following peripheral nerve stimulation and in patients suffering head-related pain.
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Authors Jonas Callens, Lisa Goudman, Koen Putman, Emily Luo BA, Julie G. Pilitsis, Philippe Rigoard, Manuel Roulaud, Maxime Billot, JAN-WILLEM KALLEWAARD, Caro Edelbroek, Maarten Moens
Journal regional anesthesia and pain medicine
Year 2026
DOI
10.1093/pm/pnag075
URL
https://doi.org/10.1093/pm/pnag075
Keywords Keywords not found

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