Pain treatment for pain treats a source of chronic back pain

Chronic pain, which lasts three months or more, occurs when the nerves continue to send signals to the brain once the initial source of pain has disappeared. An alternative to spinal cord stimulation, DRG stimulation disrupts pain signals by specifically targeting the nerves responsible for pain. This can prevent unnecessary stimulation of nerve fibers from non-painful areas, which can occur during a stimulation of the spinal cord. It also helps address the need for non-drug pain treatments in some patients.

"The people in our study who had DRG stimulation reported a significant improvement in pain even after a year, which is remarkable," said Robert J. McCarthy, Pharm.D., Lead author of the study. study and professor of anesthesiology at Rush University Medical Center, Chicago. "They had tried many therapies, from drugs to spinal stimulation to surgery, but they had not had any lasting pain relief, and for the most part, DRG stimulation had actually improved their quality of life. life."

Group of neurons located on either side of each vertebra, the DRG serves as a bridge of pain and sensations between the nerves of different parts of the body and between the spinal cord and the brain. DRG stimulation therapy interrupts the pain signal between the pain region and the brain. A device similar to a pacemaker implanted under the skin in the lower back sends small electronic pulses through a wire placed near the DRG which is connected to the nerve associated with the pain. The impulses replace the pain with another more tolerable sensation, such as tingling or numbness. The level of current provided by the device is programmed by an anesthesiologist or other pain specialist according to the patient's pain.

DRG stimulation offers two advantages over spinal cord stimulation. For these, a wire is placed along the spinal cord so that the electronic pulses are sent down the spine, but do not target the specific pain source as does DRG stimulation. In addition, DRG stimulation requires lower current levels because there is less cerebrospinal fluid covering the DRG than the spinal cord.

In this study, researchers implanted DRG stimulation devices in 67 people with chronic back pain. Patients were followed for 3 to 18 months. Seventeen patients had the device for more than one year. The study revealed:

• Prior to implanting the DRG device, most participants described their pain as 8 on a scale of 1 to 10 (10 being the most serious pain imaginable). After follow-up, the median (the most common) pain score fell to 5, a 33% decrease, which the authors note as a clinically significant improvement.
• Patients reported a (median) decrease of 27% in the disability or limitations of daily living reported by patients because of the pain.
• 94% of patients said the treatment was beneficial.
• Five patients (7.4%) had to be reimplanted, 2 (3%) were removed after being infected and 1 was removed from the device due to a complication.

"People with chronic pain need a non-drug treatment," said Dr. McCarthy. "Although it is technically more difficult to place electrodes, it may be an option for patients who have not benefited from other pain treatments and can reduce or eliminate the need for opioids." . "

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Spinal cord stimulation is a safe and effective medication-free treatment for chronic pain.