You heard the saying “No brain, no pain.” Since I haven’t run into anyone who fits that description, I’ve devoted a lot of time trying to stop pain from reaching brains. One way of doing this is through a procedure known as spinal cord stimulation. If pain impulses do not reach the brain, then pain is not perceived, just like the impulse to move is not perceived by the brain of a paralyzed patient.
In spinal cord stimulation therapy, electrical pulses block the nerve impulses responsible for pain from reaching the brain. The electrical impulses come from a special medical wire called a lead. The lead is placed between the spine and the spinal cord and connects to a power source that is implanted under the skin of the buttocks or abdomen. This power source (or pulse generator) runs on non-rechargeable batteries. When the batteries run out, the stimulator must be replaced. This happens every two or three years. You use a magnetic remote control to turn the spinal cord stimulator on and off or to adjust the intensity of the pulse.
Spinal cord stimulation can be a good choice of pain management for those who have had a failed back surgery, nerve-related pain or numbness, or a chronic pain syndrome such as reflex sympathetic dystrophy. It has also been known to help with the pain from post-herpetic neuralgia, multiple sclerosis, peripheral vascular disease, spinal cord injury and phantom limb pain. If you and your doctor decide that spinal cord stimulation is right for you, expect to have a thorough physical and psychological evaluation.
When stimulation is successful, the patient can expect a 50 percent or more reduction in pain. Jerry Lewis of comedy and telethon fame had even greater pain relief, along with significant improvement in function. Decades of falling down stairs and tripping over furniture left Jerry Lewis suffering horribly with chronic pain. After failed surgeries and dozens of trials with oral medications, he found out about spinal cord stimulation. Jerry now enjoys 100 percent pain relief! You can read about Jerry Lewis’ story (and others) on the Web site, Tamethepain.com. Instead of pain, what do you feel? Most patients (including Jerry) describe it as a pleasant tingling feeling or like seltzer water bubbles popping.
Most physicians require their patients to have a trial period of spinal cord stimulation when a temporary stimulator is implanted. This trial time is important because the patient can determine if the pain relief is satisfactory and he/she is comfortable with the feeling of stimulation. The trial period runs from 24 hours to several weeks. If the therapy works for you and cuts your pain by 50 percent, you will be scheduled for a permanent implantation. Both the trial and the permanent implantation require outpatient surgery.
All surgery comes with risks and spinal cord stimulation is no exception. But, the risks of this procedure are very low. The major risk is infection at the incision site, which, fortunately, only occurs in about 5 percent of patients.
Remember, spinal cord stimulation does not eliminate the source of the pain. It just stops the brain from reading “PAIN!” So, if you are still enduring long-term pain and have tried other treatments, you may want to discuss spinal cord stimulation with your doctor.
Thomas A. Ranieri, MD, is a specialist in anesthesiology and pain management, practicing at the Mount Nittany Pain Management Clinic.