Chronic pain is an enigma for pain doctors and their patients, both making it difficult to understand, challenging to treat effectively, and frustrating to live with.
FREMONT, CA: Desperate patients at times turn to drastic and irreversible surgical procedures, such as amputating nerves to relieve the pain, and unfortunately, even those procedures might fail to give the hoped-for results. There have been great strides in research associated with pain perception and the nervous system’s reaction to different pain treatments. Companies have developed novel devices that give many people with much-needed relief and enhance their quality of life.
Like a cardiac pacemaker corrects abnormal heartbeats, neuromodulation therapies help re-establish the nervous system’s normal function. One of the most common neuromodulation instances is spinal cord stimulation (SCS) for chronic pain management. SCS consists of a thin lead (or wire) placed in the space outside the spinal cord. The lead is stuck to a small generator device implanted under the skin and subcutaneous layer in the back or buttock. The devices will provide frequent, low-voltage electrical impulses to the spine, with subsequent modulation of the pain signals in transit to the brain. Those impulses generally feel like a gentle tingling or buzzing on the body. There have been substantial advancements in the hardware and the technology from when the first model was placed, and patients reported better pain control with reduced vibrations.
One more form of neuromodulation is the intrathecal pump; it is a device created to deliver the desired medication directly into the spinal fluid surrounding the spinal cord. This technique enables a drug to be administered in smaller doses because it does not have to be metabolized from other body systems even before reaching the target area. Smaller doses ranging 1/300 of an oral dose — can mean lesser side effects, increased patient comfort, and better quality of life. The device comprises a small plastic tube called a catheter placed in the spine’s intrathecal space, connected to the pump, and a space inside the pump called the reservoir holds the medication. This can be a pain medication or a muscle relaxant to aid in relieving muscle spasticity in certain neurological disorders such as cerebral palsy and multiple sclerosis.
Other examples of neuromodulation that are not explicitly related to pain include the use of deep brain stimulation (DBS) treatment for Parkinson’s disease; sacral nerve stimulation for pelvic disorders and incontinence; vagal nerve stimulation for migraines; and spinal cord stimulation for ischemic disorders involving the heart and peripheral vascular disease. Also, neuromodulation devices can stimulate a response where there was previously none, as in a cochlear implant restoring hearing in a deaf patient.