Mankind has searched for pain relief throughout history. Magic spells, warm rocks, animal horns, herbs taken in the moonlight – everything from the extraordinary to the sublime has been tried at one time or another. Beginning in the late 19th century, mankind began to concentrate on chemicals to create pharmaceutical medications. The results were in some ways spectacular. Many fewer people died from simple infections, inoculations prevented deadly childhood diseases and pain relief was only a pill or capsule away.
In the mid-20th century, researchers began to develop ways to relieve pain without loading patients up with high doses of potent drugs. One of the most promising seems to be spinal cord stimulation which is used in a large percentage of patients with intractable back pain and other persistent pain situations.
In 1965, the gate control theory was proposed. The theory stated that the nerves that carry feelings such as touch, vibration and pain terminated in the dorsal horn, or gate, of the spine. The theory proposed that stimulating the dorsal horn would “close the gate” to those stimuli. The work has developed to a much greater degree than those first attempts.
Candidates for Spinal Cord Stimulation
It has been found that there are two types of pain that can be addressed with spinal cord stimulation, neuropathic and ischemic. Neuropathic pain is common to diabetics. The disease damages the nerves by starving the nerves because the blood flow through the smallest blood vessels is inadequate or missing. The symptoms include loss of balance, weakness, spasms, cramps and loss of coordination. Ischemic pain results from a significant decrease in blood supply to a specific area of the body.
In the United States, spinal cord stimulation, often called neurostimulation, is most often used for Failed Back Surgery Syndrome (FBSS). FBSS is classified as a mixed pain syndrome that causes persistent pain in the lower back and/or legs. This syndrome happens not after failed but successful back surgery in about 40 percent of patients. Spinal cord stimulation is also used in patients with post-laminectomy syndrome, frequent migraine headaches and to control pain in angina.
A good candidate for spinal cord stimulation is a patient who has chronic pain in the back, neck, arms or legs lasting at least six months, has pain with burning, tingling or numbness or who have had little or no relief from surgery, pain medications, nerve blocks or physical therapy.
If a patient cannot operate the system, has an implanted cardioverter defibrillator (ICD) or a demand-type cardiac pacemaker, they are not good candidates for spinal cord stimulation.
How the System Works
Neurostimulation hijacks the pain signals to prevent them from reaching the brain. Surgeons implant a small stimulation system inside the body. The hardware outside the body is similar to a cardiac pacemaker. Thin wires (leads) are placed along the spinal canal through which small electrical impulses are sent by the outside unit. The stimulator replaces the perception of pain with a different perception. Some report a massaging sensation or just the absence of pain.
Patients can look forward to more developments in this type of pain control. Rather than becoming dependent or suffering side effects of medication, this system can help a patient reduce the dose or change the type of pain management pharmaceuticals.
Peter Wendt is a blogger living in Austin, Texas. If you are interested in learning more about spinal cord stimulation, or if you are interested in having the procedure yourself, Wendt recommends visiting www.austinpaindoctor.com/