US Department of Defense consensus guidelines on neuromodulation for pain management in an active-duty military population from a tri-service, multispecialty working group
Methodological detailsmodified Delphi approach, tri-service, multispecialty working group, 8 questions selected; 100% consensus achieved, Modified US Preventive Services Task Force grading of evidence; >50% agreement to declare a statement, >75% to affirm a recommendation
- Modified Delphi approach
- Tri-service, multispecialty working group
- 8 questions selected; 100% consensus achieved
- Modified US Preventive Services Task Force grading of evidence; >50% agreement to declare a statement, >75% to affirm a recommendation
Recommendations
As issued by the authors
Joint decision process involving the Service Member's Command before implanting a permanent device intended to improve suitability for continued service
Service Members receiving muscle (eg, multifidus) neurostimulation should be placed on limited duty for 6 months to allow improved function
An implanted neurostimulator is disqualifying for induction into the military; military occupational specialty testing recommended before retention decisions
Opioid therapy should be tapered before trialing a patient for a permanent implant
Service Members should be tested in simulated environments before deployment
Insufficient evidence to recommend full duty for >3 months without restrictions after treatment for eligibility for non-restricted worldwide deployments
Original publication
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