DEAR MAYO CLINIC: Eighteen months ago, I had surgery on my back to relieve the nerve pain that radiates down my leg. It didn’t help as much as I’d hoped, and my doctor says additional surgery isn’t likely to help. I have tried pain meds, steroid injections, chiropractic and physical therapy, but I’m still in a lot of pain. What exactly are implanted pain relief devices, and would I be a candidate for one? If so, how effective are they?
ANSWER: The pain you’re describing is called radiculopathy, and it is a type of nerve pain. There are several devices for pain relief from varied types of chronic nerve pain. Some rely on stimulating nerves with a mild electrical current. Other implanted devices deliver pain-relieving medication directly into the spinal canal. These devices are typically implanted by physicians specializing in pain management. Both types are usually considered only after more conservative options have failed, and they seldom provide complete pain relief. However, when they are effective, they can change debilitating pain into tolerable, manageable pain that allows you to function and regain your life.
Nerve stimulation devices work by blocking pain signals as they travel from the nerves to the spinal cord. In doing so, they send electrical impulses from the spinal cord out along affected nerves. These electrical impulses may produce a pleasant “tingling” sensation that can be directed to the area where you feel pain. The two main forms include:
1. Spinal cord stimulators. With these, a wire electrode is implanted in the epidural space within the spinal canal. It provides electrical stimulation on an area of the spinal column called the dorsal columns, which is where sensory nerves from the spinal cord are located.
Spinal cord stimulators are FDA approved for conditions that involve pain generated from damaged or dysfunctional nerves of the trunk, legs or arms. This includes problems such as radiculopathy, pain that persists after spine surgery, peripheral neuropathy, post herpetic neuralgia, and a condition called complex regional pain syndrome, which usually results in leg or arm pain.