Pain serves an important purpose: it tells you when the stove is too hot, when to stay off of a sprained ankle, and when you need medical attention. But pain should be temporary and should subside when the painful stimulus is removed or when healing is complete.
Sometimes, though, your body gets stuck in a pain mode that won’t stop, and nothing you try alleviates the sensation. It begins to wear you down mentally and physically. But don’t lose hope — Dr. Jay Shah at SamWell Institute for Pain Management specializes in treating intractable pain and bringing much-needed relief to patients throughout New Jersey who’ve tried everything else.
One of the ways he addresses chronic pain is with spinal cord stimulation, a therapy that effectively blocks the pain signals so they never register in your brain, and you stop feeling pain. Here’s what you need to know.
Spinal cord stimulation explained
A spinal cord stimulator (SCS) is a small device that Dr. Shah surgically implants under your skin, typically near your abdomen, buttocks, or flank area. It’s essentially similar to a heart pacemaker, but it’s used for pain. The generator has thin wires called electrodes that Dr. Shah strategically places in the epidural space between your spinal cord and your vertebrae.
Once in place, the SCS sends out low-level electrical impulses that change the way your brain and spine process and perceive pain. SCS can be extremely beneficial for persistent nerve pain after neck or back surgery or pain from complex regional pain syndrome (CRPS/Reflex sympathetic dystrophy (RSD)).
Types of spinal cord stimulators
Depending on several factors, including the source of your pain, the location, the length of time you’ve experienced it, the frequency and severity, and the amount of signal it takes to elicit a response, Dr. Shah recommends the best type of SCS for you. Fortunately, Dr. Shah has access to all the most advanced methods of SCS devices and can tailor the best treatment to to your needs and lifestyle.
The most basic method involves an implantable generator that activates the spinal cord stimulator through electrical leads. This is a great choice if you have pain in your neck or down your arms after neck surgery, or in your back or legs after lumbar spine surgery.
The battery life expectancy is about 10 years, and it needs to be upgraded and replaced at that time.
Peripheral Nerve Stimulation
This device is different, because its battery pack lies outside your body, and it comes with a remote control to regulate the frequency and intensity of the stimulation. The device works for a period of 60 days and is then removed, providing sustained long-term relief of your pain. This method is generally considered for refractory peripheral joint pain or to pinpoint a pain-causing area. Dr. Shah places the electrodes near the nerves that control pain exactly where you feel it.
Dorsal root ganglion (DRG) stimulation
Your dorsal root ganglion is a network of nerves that lies within the epidural space of your spine. The DRG stimulation process is very similar to the traditional SCS procedure, but the SCS treatment offers a broader electrical stimulus, while DRG stimulation affects more precise nerve fibers that can target specific pain.
Am I a candidate for SCS/DRG?
Before recommending SCS, Dr. Shah completes a thorough medical exam to make sure you are otherwise healthy enough to withstand the minor surgical procedure. He also makes sure you aren’t suffering from any other issues that may hinder your success with an implantable SCS device, especially if it involves self-administration with the remote device.
While spinal cord stimulation has specific indications of use for the treatment of chronic pain, Dr. Shah finds that his patients with the following chronic conditions tend to respond very well to this therapy:
- Arachnoiditis: inflammation of the lining in your spinal cord
- Complex regional pain syndrome: typically caused by surgery, injury, stroke, or heart attack
- Reflex Sympathetic Dystrophy (RSD)
- Failed back surgery syndrome: back and leg pain following surgery
- Failed neck surgery syndrome: neck and arm pain following surgery
- Spinal stenosis
- Degenerative disc disease
- Nerve root compression
- Peripheral nerve injury after trauma
Each one of these conditions can cause lasting pain that may not be treatable in traditional ways, and that’s where spinal cord stimulation comes in. But before committing to a permanent surgical implant, Dr. Shah runs one final test.
The all-important trial SCS
In order to determine whether SCS can work for you, Dr. Shah conducts a temporary seven-day trial of the device that’s external. Once you’re comfortably numb from local anesthetic, he inserts a needle into your epidural space and then threads the electrical leads through the needle and into the source of your nerve pain.
Over the next several days, and up to a week, you use a wireless remote device to deliver electrical impulses that block the signals to your specific areas of pain, and you’ll be in daily contact with Dr. Shah’s staff and the device company for adjustments that can be made remotely. If you experience at least 50% pain relief or more, the trial is considered a success, and you and Dr. Shah can together discuss your options for long-term placement of the SCS implant.
If you’re suffering from chronic pain that won’t respond to traditional treatments, call us at either our Colonia or Livingston, New Jersey locations, or book an appointment online to find out if you are a candidate for SCS, DRG, or peripheral nerve stimulation.