NEUROSTIMULATION FOR THE TREATMENT OF CHRONIC PAIN
Neurostimulation | Indications | Methods | Treatment | Benefits and risks | Consultations
Pain is a complex sensation that can have a variety of causes. Neurostimulation, in particular SCS and DRG stimulation, offers a promising option for the treatment of chronic pain when other options have not been sufficiently effective.
Neurostimulation is a promising approach for the treatment of pain, especially when other methods are insufficiently effective.
There are two types of neurostimulation:
- Spinal cord stimulation (SCS)
- Dorsal root ganglion (DRG) stimulation
Spinal cord stimulation (SCS) involves the implantation of a small device that sends electrical pulses to the spinal cord. These pulses can block or mask the pain signals before they reach the brain, which can provide pain relief.
Dorsal root ganglion (DRG) stimulation aims to provide targeted stimulation to the nerve roots associated with specific painful areas.
Neurostimulation is often used for chronic pain that does not respond adequately to conventional treatments. This can be pain after back surgery, complex regional pain syndrome (CRPS), groin surgery, knee surgery, sciatica or neuropathic pain.
Prior to implantation, the patient undergoes a comprehensive evaluation to ensure that they are a suitable candidate for the treatment.
Spinal cord stimulation (SCS) is a procedure in which weak electrical signals or pulses are sent to your spine to relieve pain. These pulses are delivered by a small device that is implanted under your skin. The electrical pulses block the pain signals that are sent from the spinal cord to the brain. This can provide you with noticeable pain relief and improve your quality of life.
Spinal cord stimulation is usually indicated for people with chronic pain for whom other conservative treatments have not produced the desired results. SCS is typically considered in the following cases:
1. Neuropathic pain:
If you have chronic pain caused by nerve damage, such as diabetic neuropathy, complex regional pain syndrome (CRPS) or post-herpetic neuralgia.
2. Back or leg pain:
If you have persistent pain in your back or legs due to spinal problems such as slipped (herniated) discs, degenerative changes or failed back surgery syndrome.
3. Ischemic pain:
If you have persistent pain due to insufficient blood flow to certain areas of the body, such as peripheral artery disease (PAD).
It is important to note that the final decision on the suitability of SCS is made on an individual basis. Your specialist will carefully evaluate your medical history, pain symptoms and quality of life to determine whether SCS is an appropriate option for you.
DORSAL ROOT GANGLION STIMULATION
Dorsal root ganglion stimulation (DRG stimulation) is a procedure for the treatment of chronic pain, especially neuropathic pain, that originates from specific nerve fibres in the spinal cord. Here is a brief summary of how DRG stimulation works:
DRG stimulation is a therapy that involves stimulating the nerve fibres in the dorsal root ganglion (DRG). The DRG is part of the spinal cord and contains the cell bodies of the sensory nerve fibres that transmit pain signals. By sending weak electrical pulses to the DRG, the transmission of pain signals can be blocked or modulated.
In contrast to spinal cord stimulation (SCS), in which the electrical pulses are directed at the spinal cord as a whole, DRG stimulation focuses on specific DRG areas that are responsible for transmitting the pain signals. This targeted stimulation can achieve more precise pain relief, particularly in areas that are especially painful for the patient.
DRG stimulation is generally used for people who have tried other conservative therapies such as medication, injections or physiotherapy and these have not provided sufficient pain relief. It can be particularly effective for neuropathic pain in specific regions of the body such as the extremities, trunk or pelvic area.
Before the procedure, a careful assessment is carried out to determine the exact location of the pain and check the individual suitability for DRG stimulation. The procedure is usually performed by an experienced pain specialist and involves the implantation of a small device that generates the electrical pulses and transmits them to the DRG.
Dorsal root ganglion (DRG) stimulation is a neurosurgical procedure for the treatment of chronic pain.
Dorsal root ganglion stimulation is most effective for certain painful conditions such as:
- Complex regional pain syndrome (CRPS), formerly known as Sudeck’s atrophy
- Postherpetic neuralgia (pain after shingles)
- Nerve injuries and neuropathic pain
- Phantom and residual limb pain after amputations
- Pain after intervertebral disc surgery
- Pain after knee surgery
However, the exact effectiveness and suitability of DRG stimulation can vary from case to case. It is important that the specialist treating you performs a thorough examination and evaluation to determine the best possible treatment option.
Please note that this information is a general overview and readers are advised to contact a specialist in neurosurgery or pain management for individual advice and information.
It is important to note that these procedures may not be suitable for every patient. Your specialist will inform you about the possible risks, benefits and alternatives in order to make the best decision for your treatment together with you.
Preparation of the patient:
The patient is informed about the procedure. Appropriate preliminary examinations are carried out before the procedure to confirm the patient’s suitability for SCS or DRG stimulation.
Before the procedure, a local anaesthetic is administered at the planned injection site for pain relief.
Placement of the electrodes:
Thin wires (electrodes) are inserted into the target area under X-ray guidance. The exact placement of the electrodes is confirmed by electrophysiological measurements and patient feedback.
After the electrodes have been placed, a test phase is carried out in which the electrodes are temporarily activated to check the effectiveness of the stimulation. The patient is asked to rate their pain relief and any possible side effects.
Implantation of the pulse generator:
If the test phase is successful and significant pain relief is achieved, a pulse generator (stimulator) is implanted under the skin. The pulse generator is connected to the electrodes and generates electrical signals to stimulate the spinal cord/dorsal root ganglion.
Neurostimulation can significantly improve the quality of life of people with chronic pain. It can reduce the need for pain medication and increase mobility.
Nevertheless, this treatment also involves risks such as infection, displacement of the implant or unwanted electrical effects.
Dr Alessandro Rustia has many years of experience and is highly skilled in spinal surgery and pain management. We ensure rapid, expert assessment and consultation as well as treatment encompassing the latest medical possibilities. Don’t hesitate to get in touch if you would like a second opinion.
Because the Pyramid Clinic is a private clinic, patients here require supplementary insurance. You will therefore need private or semi-private insurance for your treatment. If you have general insurance, you can also be treated here if you opt to pay for an upgrade.