Mark J. Downey, MD & Alex Cotter, MD
10 Old Montgomery Hwy #200. Homewood, AL 35209
Appointments & Referrals: (205) 271-6511
According to a study by the National Institutes for Health, 25.3 million adults in the U.S — 11 percent of the adult population — said they experience pain symptoms every day for the past three months.
This ongoing pain is called “chronic pain” and is in contrast to “acute pain” which may start with an injury and then disappear as the injury resolves.
There can be many reasons for chronic pain. In the area of back and neck pain, those patients who have had spine surgery that didn’t relieve symptoms are often referred to as “failed back surgery syndrome.” Failed back surgery syndrome can be caused by scarring around a nerve root that then is hypersensitive and transmits pain signals to the brain, much like an electrical switch that is stuck in the “on” position.
Chronic pain causes physical and emotional suffering, time off work and dependence upon drugs that can damage internal organs and shorten one’s lifespan.
The use of drugs to mask symptoms creates serious issues. Many drugs have side effects that can damage the kidneys or liver which will shorten a person’s lifespan. Other drugs can be addictive and can destroy a person’s lifestyle.
Decades ago, pain management specialists tried to develop a method of relieving pain that didn’t mask pain symptoms as drugs attempt to do, but rather interrupt the pain signal to the brain. “Neuromodulation with Spinal cord stimulation” (SCS) was one of the most exciting developments in chronic pain management. It has been used for approximately four decades in treating chronic pain specifically for nerve damage in the low back.
For those with chronic pain, the typical options for relief include:
The final option that can be provided to those with chronic pain is Spinal Cord Stimulation. Spinal cord stimulation is based on the “gate theory” of pain, where a pulse generator delivers mild electrical pulses to the spine at precise intervals where a wave of pain would normally be transmitted to the brain. The person then feels a tingling sensation rather than a wave of pain.
Said another way, the pain signal is being interrupted on the way to the brain, which can eliminate or reduce the need for drugs.
During a spinal cord stimulator procedure, the physician implants a small stimulator device, much like a heart pacemaker, under the skin by the upper buttock or adbdomen to deliver electrical pulses.
The spinal cord stimulation system also includes a handheld programming device that acts as a remote control. There are wire leads that are attached under the skin to the precise level of the spine that is causing the pain signal.
Spinal Cord Stimulation requies patients to go through a screening procedure that applies the leads to the level of the spine on the exterior of the skin before the device is implanted under the skin. This enables the physician to determine if the device will be effective and the exact position of the wire leads on the spine that provides the best relief of pain. During the procedure the patient is awake as the physician adjusts the placement of the wires to the level in the back that provides the most pain relief to the patient. Through this procedure the patient provides immediate feedback to the physician as to what placement provides the best relief of pain symptom.
When implanted correctly, a spinal cord stimulator interrupts the waves of pain that are transmitted from the damaged nerve. The neuromodulation unit instead sends a small electrical signal at the precise moment that the nerve is transmitting a pain signal. The result is that the patient feels a small electrical pulse instead of a wave of pain.
The best benefit of spinal cord stimulation is that it can lessen the need for drugs for those patients who suffer from chronic pain related to the low back.