Neurostimulation for Treatment of Chronic Upper Limb Pain After Brachial Plexus Injury

This study is examining a treatment for chronic, severe arm pain that results from brachial plexus avulsion injury — a traumatic injury where the nerves connecting the spinal cord to the arm are torn away. This type of injury often causes relentless burning or shooting pain that does not respond well to standard pain medications. The treatment being studied is high-frequency spinal cord stimulation (SCS), where a small device is implanted to send electrical signals to the spinal cord to interrupt pain signals. Researchers want to understand how well this type of neurostimulation works for patients with this specific injury and what factors predict a good outcome. Participants must already be scheduled to have the SCS device implanted as part of their regular care — the study is observing their outcomes before and after the procedure. You may be eligible if: - You are 18 or older - You have neuropathic (nerve) pain in the upper arm/limb lasting 3 or more months after a brachial plexus avulsion injury - You are already scheduled to receive a spinal cord stimulator implant for this pain - You have tried at least 3 months of conservative treatments including physical therapy and neuropathic pain medication You may NOT be eligible if: - Your pain is not classified as neuropathic (DN4 score less than 4) - You are pregnant or plan to become pregnant during the study - You have an active substance use disorder - You currently smoke - You take high-dose opioids (more than 100mg oral morphine equivalent per day) - You have an active untreated psychiatric disorder - You are involved in active litigation related to your injury Talk to your doctor to see if this trial is right for you.