Effective Spinal Cord Stimulation Does Not Improve Caregiver Burden in Patients With Chronic Neuropathic Pain. Results of the CARESTIM‐Study

Background Spinal cord stimulation (SCS) is a well‐established treatment for chronic neuropathic and ischaemic pain. Although patient‐reported outcomes have increasingly gained recognition, the impact of SCS on informal caregivers—an equally important consideration—remains underexplored. This study aims to address this gap by evaluating multidimensional outcomes following SCS, with a particular focus on the burden experienced by informal caregivers over a one‐year period. Methods A prospective cohort study was conducted involving 35 patient‐caregiver dyads treated with SCS between January and December 2021 at AZ Delta and Jan Yperman Hospital. Inclusion required the availability of a spousal or offspring caregiver. Patients and caregivers were evaluated preoperatively and at 3, 6 and 12 months postoperatively using validated instruments including the Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), EuroQuality of Life‐5 Dimensions (EQ5D), Zarit Burden Index (ZBI), Modified Caregiver Strain Index (MCSI) and Relation Quality Indexes (RQI). Results Patients reported significant reductions in leg and back pain ( p < 0.001), leading to decreased disability ( p < 0.001) and improved quality of life ( p < 0.05) during follow‐up. However, no significant changes were observed in caregiver burden or in the quality of the patient‐caregiver relationship. Conclusions While patients reported significantly lower pain and better quality of life following SCS, these benefits do not extend to reducing caregiver burden or strengthening the patient‐caregiver relationship. A holistic treatment approach that actively involves caregivers may be necessary to optimise outcomes for both patients and caregivers. Further research with a larger cohort is required. Significance Statement This prospective cohort study is the first to analyze the patient‐caregiver dyad in chronic pain patients treated with SCS. Although SCS effectively reduces pain and improves the quality of life of patients, these benefits do not extend to reducing caregiver burden or enhancing the patient‐caregiver relationship. We argue that a more holistic approach, including caregiver involvement in the treatment process, may be necessary to improve outcomes for both patients and caregivers.