We’ve all been there.
You bend down to pick up a pencil, you turn the wrong way in a chair or you lift something mildly heavy. Suddenly, a lightning bolt of pain shoots down your spine.
It’s one of the most common ailments in the United States. This year, 50 percent of all Americans will experience some sort of back pain. The same was true last year. The same will be true next year.
But while back pain is the second most common reason for visits to the doctor’s office in the United States, it’s often more difficult to identify a cause as compared to other injuries.
“If somebody is in a car accident and they have a broken tibia, you see it in an X-ray,” says Matthew Karek, MD, an orthopedic spine surgeon with the Spectrum Health Medical Group Spine & Pain Management Center. “That’s often not the case with back pain. There’s a lot of nuance to what we do.”
The majority of Americans who experience back pain can find relief with rest, stretching and simple rehabilitation, Dr. Karek says.
But for those with chronic pain and a negative work-up—an unidentifiable cause of the pain—a rapidly improving technology and simple surgery can often provide relief.
Stimulation
Spinal cord stimulation has been around since the 1980s.
The technology has evolved in recent years, however, to make it a much more effective, convenient and viable option for those with chronic back pain that can’t be repaired by surgery. It’s especially useful when the cause of the pain can’t pinpointed.
The procedure starts with a small device implanted under the skin. The device sends electrical impulses to the dorsal column of the spine, where pain signals travel from the body to the brain. The pulses provide a pleasant tingling sensation that overrides the pain signals.
For many patients, the device severely reduces or altogether eliminates the feeling of pain.
Spinal cord stimulation treats the symptom and not the cause, but for those who have experienced months or years of chronic back pain, that can still make a world of difference.
“(Spinal cord stimulation) doesn’t do anything to alter the underlying course of the disease,” said Jason Squires, DO, an orthopedic spine surgeon with the Spectrum Health Medical Group Spine & Pain Management Center. “But sometimes people have painful diseases or chronic pain, which is stable—it’s not getting better or worse—and we haven’t been able to alleviate the pain that person is feeling. So we use this to alleviate that pain.”
Long-lasting success
The process works like this: A patient gets a diagnosis of pain. They go to see a pain management physician or orthopedic surgeon or neurosurgeon, but the doctors can’t identify a specific cause or solution.
The pain doctor will then try a temporary spinal cord stimulator and let it run for a week, Dr. Squires said.
The temporary device has some loose-hanging wires, but patients can still go through routine daily activities. The patient can also adjust the frequency and strength of the pulses using a small radio controller the doctor provides.
At the end of the week, the pain doctor asks if the stimulator has helped. If it has reduced the pain by more than 50 percent, the patient becomes a candidate for a permanent device.
The permanent stimulator has no wires. The battery lasts for up to nine years, and the patient must charge it every one to two weeks using another small wireless device.
About 75 percent of the patients who end up on the permanent device see a significant or complete reduction in pain, Dr. Squires said.
“The ones who benefit from the temporary device, they come in and say, ‘It’s unbelievable!’ ‘A miracle!’ ‘I wanted it put in yesterday!’” Dr. Squires said. “The ones who it doesn’t seem to work great for were unsure the temporary one was working, but told the pain doctor it did work because they were desperate and hoped it worked better than it actually did. But usually if the temporary one works well, the patient will have a lot of success with the permanent one.”
The implementation of the device is usually done as outpatient surgery. It takes about 45 minutes to an hour with little blood loss, low infection rates and little risk to the spinal cord.
“Most people, a month or so out from the surgery, are feeling pretty much recovered,” Dr. Squires said. “The technology has continued to evolve and really come a long way. It’s not really comparable to anything we had before.”
Any chance this will work after several L 3-4-5-S 1 fusions and now with severe spinal stenosis?
Hi William! Thanks for reading Health Beat and for your question. We’d suggest you reach out to the experts at Spectrum Health Medical Group Spine & Pain Management Center to ask about your personal health situation. You can call them at 616.774.8345. Best wishes to you! 🙂
Hi!
I am writing on behalf of my aunt who lives in Florida. She has a great deal of back pain, but has been told by her orthopedic spine surgeon that he will never perform surgery on her spine, as it would never help.
Is there any specific name for this spinal cord stimulator? I think her best option is to find a Spine and Pain Management Center in Florida and the more information I can give her the better!
Thanks for any information you can relay to me!
Hi Barb. Thank you for your inquiry and for being a Health Beat reader. It looks as though Medtronic makes a spinal cord stimulator, also sometimes called a dorsal column stimulator. Here’s a website that has a physician finder per zip code (since your aunt is from Florida and plans to seek treatment there): http://www.tamethepain.com/chronic-pain/spinal-cord-stimulation-neurostimulation/long-term/ Hopefully this option will help your aunt. Best, Cheryl
Thank you! I have forwarded this information on to my Aunt.
Barb Curtis
Sure thing! Hope it helps her! 🙂
I live in northern Michigan and just had the MedTronic Nerve Stimulator Implant surgery 3 weeks ago. (I don’t live near Grand Rapids). The 1 week trial went well, so the neurosurgeon did the implant. I originally had a ruptured disk back in 1991 and was diagnosed with degenerative disk disease and degenerative arthritis. I have had 3 neck surgeries and the last one in 2004 ended with a metal plate and 4 screws. After 25 years of chronic pain, I have no arm or neck pain (C7 radiculopathy) with the stimulator. I can’t believe the difference. I would strongly recommend this for anyone who has chronic pain.
Thank you for sharing your personal experience, Kim! We’re glad to have you as a Health Beat reader and super happy you’re feeling much better these days! Cheers, Cheryl
If you have one of these implanted, can you still have an MRI?
Hi Sandy! Thanks for reading and commenting. We suggest you discuss this with your doctor as he or she will be best able to provide guidance. Best wishes!
Would appreciate if you give me a appointment asap!!! I have been in chronic pain for over a year and I haven’t been able to run all over because of my back and it has aC-fracture therasis, lumbar, and lower part of back. My wrist is broken in 2 places and pelvis is fractured
Hi Jimmy, We are sorry to hear you have been dealing with this pain. If you have a concern regarding scheduling an appointment and would like assistance, you may contact our Patient Relations Department at 616.391.2624 or via email at patient.relations@spectrumhealth.org.