There are many different treatments that are available for people trying to manage their pain, and many people can find themselves spending up to find the "right" treatment. It is important to prepare yourself.
- Do your homework. Find out as much as you can about what you are considering
- "Interview" the provider. Find out what they know about chronic pain in particular - make sure you have read the pain physiology section on this site. It is likely that someone who is helpful for you will know this stuff.
- Try it out. If you don't find you have improved don't continue beyond a few sessions.
During National Pain Week 2013 we made a program about medical acupuncture.
Feldenkrais is a therapy that operates on the basis of neuroplasticity.
During National Pain Week in 2013 we made a video to explain this treatment.
What is Neuromodulation?
Neuromodulation (also called spinal cord stimulation, or SCS) is a proven therapy to manage chronic pain and improve quality of life. Neuromodulation systems deliver electrical pulses to the spinal cord or peripheral nerves, modulating the transmission of pain signals to the brain.
With this therapy, a small device is used to interrupt pain signals before they reach the brain. The painful feeling is replaced with a different feeling; which some describe as a gentle massaging sensation or, in some cases, simply the absence of pain.
Unlike many options for managing chronic pain, you have the opportunity to try neurostimulation before making a commitment in order to make sure it is the right therapy for you.
How Neuromodulation works.
1. Pain signals travel up the spinal cord to the brain.
2. A generator (similar to a pacemaker) sends pulses to a thin wire called a “lead”.
3. The lead delivers these pulses to nerves along the spinal cord.
4. The pulses block pain signals before they reach the brain.
While neurostimulation helps most patients receive at least some reduction in pain, not everyone responds in the same way. The amount of pain relief varies with each individual. Complications related to placement and/or use of the device may occur. Be sure to discuss the risks and benefits of neurostimulation with your doctor.
Neuromodulation is a Two Step Procedure
Step 1: Trial Stimulation
An important feature of Neuromodulation is the ability to trial the therapy. This enables the patient to experience Neuromodulation and get a good indication of how much pain reduction is possible. The trial involves a minor operation where leads are placed via an epidural Tuohy needle and connected to a temporary external stimulator. These leads are easily removed at the end of the trial.
Step 2: Implantation of Permanent System
If the trial is successful, the permanent procedure requires small incisions to implant the leads. A subcutaneous pocket is created, usually in the buttocks area. The leads are connected to the implantable pulse generator (IPG) and secured in the pocket. The patient is able to control the therapy with a wireless programmer.
What is Dorsal Root Ganglion (DRG) stimulation?
DRG Stimulation is a form of SCS that targets a branch of the spinal cord called the Dorsal Root Ganglion (DRG). The DRG has been a target for physicians for pain relief for many years. The DRG can regulate pain signals before they enter the spinal cord and travel to the brain. The DRG acts like a traffic light and controls when sensations can enter the spinal cord. Stimulation at the DRG can create more red lights which may prevent pain signals from traveling to the brain. This provides a comfortable tingling or even an absence of pain.
One-year outcomes of spinal cord stimulation of the dorsal root ganglion in the treatment of chronic neuropathic pain. HERE
More about dorsal root ganglion stimulation from the UK HERE
In the news 15 October 2015:
Patient fitted with world first spinal cord stimulator to treat chronic pain at Royal North Shore Hospital.