Neuromodulation for Chronic Pain Disorders


About Neuromodulation for Chronic Pain Disorders

Chronic pain is pain that lasts beyond the point an injury has healed or after the time an illness has passed. Chronic pain that has not responded to other treatments may respond to neuromodulation. The term “neuromodulation” describes a treatment that uses electricity (neurostimulator) or drugs (medication pump) on nerves to change their activity.

Neuromodulation does not eliminate chronic pain completely. The treatment does not address the source of the pain – it merely interrupts pain signals on their way to the brain. If your pain is the result of a physical problem, most doctors will recommend treating the pain’s source first. Typically, the procedure reduces the pain by 50-75%, and treatment is considered successful if pain is relieved by at least 50%. This therapy is only used for patients whose conditions have not improved with other treatments.

Devices & Treatment Options

Your physician may decide between one of two device types: a spinal cord stimulator (SCS) or a peripheral nerve field stimulator (PNFS). In SCS, wires are placed in the patient’s back near the spinal column. In PNFS, wires are placed under the patient’s skin in the area near the nerves that are sending the pain signals.

Aside from wire placement, both devices are the same. The devices are made up of two parts – an electrode and a generator – put in the body during separate surgeries. SCS involves a short trial (usually a week) with a temporary device to make sure the pain is relieved. If the level of pain has gone down, a permanent system can be implanted.

The electrode is the wire that carries the electricity from the device to the affected area of the body. The first surgery is done with the patient awake so they can give feedback on the level of pain control. If pain coverage is adequate, a second operation will be scheduled to implant the generator. Neuromodulation devices can be programmed by the doctor and controlled by the patient to ensure proper pain management under safe conditions. Patients may turn the device down when pain is at a low level, and increase the stimulation when pain is at a higher level.