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Neuropathic Pain

Neuropathic Pain

Chronic, intractable neuropathic pain afflicts millions of Americans, seriously degrading its sufferers’ quality of life. As every physician knows, diagnosing and treating complex pain conditions can pose a significant challenge. Neuropathic pain often resists conventional pain management therapies, including strong drug regimens.

While various types of neuropathic back pain are receiving increased attention in the medical literature, there is still a lack of knowledge in the community about this type of chronic pain and options for its treatment. There are hundreds of thousands of patients suffering from chronic spine pain and the majority of them can benefit from Spinal Cord Stimulation (SCS).

Spinal Cord Stimulation (SCS)

Figure: Implanted SCS electrodes.

Spinal Cord Stimulation (SCS) is an advanced neuromodulation technology that offers effective methods for treating chronic pain of neurologic origin in the back, trunk, and limbs. SCS gives us a clinically proven, drug-free therapy that has been successful in treating pain associated with conditions such as postlaminectomy syndrome, axial low back pain, radiculopathy, peripheral neuropathy, and Complex Regional Pain Syndrome (CRPS).

Pain signals travel along the spinal cord to the brain. SCS therapy applies electrical doses directly to the nerve fibers, changing the pain signal into something the brain interprets as a sensation called “paresthesia.” Patients generally describe it as a gentle tingling or massage-like feeling.

First Step: Trial Period

The first step in SCS therapy is a minimally invasive, reversible outpatient procedure in which the patient receives a temporary, nonimplanted (external) system. Wire leads connect the external trial device to electrode contacts placed over the spinal cord. The system delivers electrical impulses that can mask pain signals.

Second Step: IPG Procedure

Next, a small, rechargeable implant called an Implantable Pulse Generator (IPG) is surgically placed in a comfortable, convenient position under the patient’s skin. Patients often remain awake during this procedure; under local or light anesthesia. Flexible leads that were inserted in the epidural space near the spinal cord are connected to the IPG unit. Each lead has a number of tightly spaced electrode contacts (Figure). The IPG unit produces electrical impulses that travel along the leads to the contacts to deliver pain-masking signals. Afterward, the patient controls the stimulation fields with the same remote control unit used during the trial period.

Click this link to read more about conditions that can be treated with SCS.