Innovative options for long-term pain relief
Most of us have heard of steroid injections for pain — one treatment available for chronic or acute pain. But according to Dr. Mansoor Aman, an interventional pain management physician at Aurora Health Care, there have been several relatively recent breakthroughs that are lesser known.
Dr. Aman explains that chronic pain that lasts greater than three months is different from acute pain after an injury or surgery. There is often “central sensitization.” This occurs when pain is encoded by the brain and you continue to experience pain even though your imaging tests don’t show any injury or inflammation. Doctors can use nerve stimulator devices to reduce your pain from these painful stimuli.
Nerve stimulation offers different advantages depending on where the lead is placed. Stimulation is often felt as a massage-like sensation. Sometimes it runs in the background without any sensation at all.
To make sure the right spot has been identified, your doctor will usually start by inserting a temporary lead. This also helps you learn how to use the controls of the unit to choose different patterns and levels of stimulation. After you and your doctor are both satisfied that it’s helpful in reducing your pain or increasing function, the temporary unit will be removed and a permanent one will be implanted.
There are three relatively new types of nerve stimulation:
- Dorsal root ganglion spinal cord stimulation: Stimulator leads are implanted near the spinal nerves at an important target in pain processing (the dorsal root ganglion). Some indications for using this method include complex regional pain syndrome, post-surgical pain or neuropathy.
- Spinal cord stimulation: Stimulator leads are implanted near the spinal column and can target a large area in the body (for example the entire lower back and both legs). The newest indication is painful diabetic neuropathy. Other conditions that may benefit from spinal cord stimulation are persistent post-surgical syndrome (PSPS), complex regional pain syndrome (CRPS) and lumbar radiculopathy.
- Peripheral nerve stimulation (PNS): Stimulator leads are placed at a named nerve that is responsible for carrying pain to a specific area. They are implanted just under the skin. Common targets are the suprascapular nerve for shoulder pain, the saphenous nerve for knee or ankle pain, or the sciatic nerve for foot and ankle pain. This method can be offered as a 60-day treatment that provides sustained relief post-treatment or as an implanted permanent option.
In addition to muscle stimulation, there are three relatively new procedures used to treat pain:
- Minimally invasive lumbar decompression: Useful for back and leg pain, this procedure uses a tiny incision to remove tissue that is pressing on nerves and causing pain.
- VIAdisc allograft intradiscal injection: Injects a proprietary strain of cells into a damaged disc in your back to stimulate new growth that repairs the disc.
- Intracept procedure: Uses a specialized tool to deliver radiofrequency energy to treat the basivertebral nerve and block pain in your back.
“These methods are providing new opportunities for long-lasting pain relief for millions of people,” says Dr. Aman.
Advantages of these interventional pain management treatments:
- Not addictive
- Can be done in a doctor’s office or as an outpatient procedure
- Can be done repeatedly, providing long-term relief
- Little to no recovery time needed and few complications
- Good option for people who aren’t good candidates for surgery
- Usually less expensive than open surgery
- Treatments are often covered by Medicare or insurance
While no single treatment is guaranteed to provide the relief you need, Dr. Aman says that interventional pain procedures work well for both chronic pain that may have lasted for years and acute pain that is expected to be short-lived, such as after an operation or after an injury that is still healing.
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About the Author
Jo Linsley, a health enews contributor, is a freelance copywriter at Advocate Health Care and Aurora Health Care. With decades of experience in writing and editing, she continues to aspire to concise and inspiring writing. She also enjoys knitting and singing as creative outlets and for their meditative qualities.
Not everyone has success with SCS. I’ve had four for CRPS/RSD of my upper and lower bilateral limbs, shoulders and back. The last one was a a combined low and high frequency implant from Boston Scientific that was a complete bust. It caused more pain in all settings and I had complications from severe adhesions surrounding the previous leads. Please take everything into consideration before getting one, they are not a panacea.
I had a anterior and posterior back fusion. Even though it’s been over 10 years. I still suffer from low back pain.
I had both hip and knees replaced. I suffer from knee pain that can be extremely painful. I have had several procedures done, and they are short lived. Is there anything thing that I can do to relieve the pain.
That’s all fine and dandy. I can’t get it because I have to be on 2 blood thinners and am unable to have the leads placed. So get outta my medicine cabinet and keep the opioids coming.
I’ve had all 3 of these procedures plus nerve blocks,steroid shots, and 3 spinal fusions they are all a joke.
Spinal cord stimulators are a piece of junk. Just another big money maker for the medical companies like Medtronic.
I suffer from fibromyalgia migraine
depression and anxiety with sleep apnea.
I am having a painful fibromyalgia flare which has lasted 3 days.
Taking ketamine at brekkie time and panadeine forte and anti inflammatories
What more can I do
Who in Richmond VA would be able to do this type of chronic pain management?
I had back surgery in May and having more pain now, laminectomy and L3,45 fusion.
Do any of these nerve stimulation procedures work for lower lumbar stenosis and vise like foot pain.
What is a delicate way to approach the doctors that you deal with about these procedures? I don’t dare insult them by acting like I know more than they do. But One of the scenarios sounds like a perfect solution to what I’m going through.
I have chronic pain due to I need a hip replacement and I was injured on a job with neck surgery back in 2015 or surgeries and it still hurts now I need a hip replacement and the pain will not stop even with the pain pills I’m on
My SCS is from Abbott for CRPS in my feet. It really helped, but I do still need medication for the pain, just not as much. The only downside I had was that at first it made me have back pain where there was none before. Once they adjusted where it would cover, my back was better too.