2. Peripheral nerve stimulators. Placed along nerves that branch off from the spinal cord, these may be used for pain arising from numerous peripheral nerve problems, including remaining leg pain after back surgery, post-herpetic neuralgia and some types of headaches.
Peripheral nerve stimulators are more targeted to a specific nerve or group of nerves than are spinal cord stimulators. Occasionally, spinal cord and peripheral nerve stimulators are used in combination to achieve better pain relief.
Determining if one or both nerve stimulation devices are right for you depends on many factors, including the cause of your pain, its location, your overall health and your ability to care for an implanted device. If your doctor thinks you may be a candidate, you’ll likely undergo a stimulation test with a temporarily placed electrode to find out how well you respond to the therapy. If the device had a beneficial effect, the wire electrode and the electrical generator (or battery pack) can be fully implanted under the skin during a separate surgical procedure.
Technically called intrathecal drug delivery systems, these deliver pain medication directly into the fluid that surrounds the spinal cord. They’re most often used to relieve pain from cancer or to relieve chronic back pain that’s unresponsive to more conservative therapies. They also may be used as a “last resort” option for certain types of severe chronic pain. They may be considered if a nerve stimulator fails to provide relief, or rarely, in conjunction with a nerve stimulator.
Medication pumps consist of a small flexible catheter that’s placed in the spinal fluid. The catheter is connected to a drug infusion pump that’s implanted into your lower abdominal wall. The pump is programmed to dispense the drug it contains — often opioid pain medications (such as morphine) or other medications to treat nerve pain — at a set rate and can be refilled with an injection through your skin and into a sealed port on the device.