Pain Treatment Centers

Stephen T. Pyles, MD-Spinal Stimulation Therapy for Pain Management

 What is Spinal Cord Stimulation?

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Spinal cord stimulation Spinal cord stimulation is a method that can be used to treat chronic back pain. This is a serious issue for many people who find that this pain can slow them down significantly or even interfere with activities of daily living, leaving them homebound and without relief. Spinal cord stimulation is one way around the problem, with an alternative that can be implanted in your doctor’s office.  However, it helps to know how it works to know whether or not this is an option to treat your chronic pain issues.

The process relies on an electrical current that is implanted in the back and sends electric pings to the spinal cord. These pings stop the nerve receptors in your spine from allowing you to feel pain. It is generally conducted using a simple sedative and a local anesthesia medication and is often done once as a test to see how your body — and back pain – responds to the treatment, before scheduling for a full course of spinal cord stimulation treatments.

Moreover, if you respond well to the treatment, your doctor may install a permanent stimulator in your abdomen, just under the skin, with wires inserted that lead to the place in your spine where the pings are necessary. The insertion of the stimulator into the abdomen is perfect for greater stability under the skin.

You can use spinal cord stimulation for an hour or two each day, three to four times a day. It will cause a tingling feeling in the back instead of the extreme and limiting pain you may have experienced in the past. This is perfect for those with chronic pain that has not responded to other forms of treatment, including medications and physical therapy.

There are risks, including infection, headaches, bladder issues and more associated with spinal cord stimulation. However, for many patients, the benefits far outweigh any risks and provide an “out” to those that have felt forced to live with chronic back pain.

However, it should be noted that this is an option that should be considered only after other less-invasive options have been exhausted, including physical therapy for the back to reduce inflammation and promote natural healing. Spinal cord stimulation is best, in fact, for those that have tried other options and feel frustrated that nothing has worked.

Causes of Chronic Pain

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painChronic pain can wreak havoc on your entire life, not only causing physical anguish, but also mental depression as well. This is, in part, due to the lasting nature of this type of pain and also because for some conditions, there is no way out of it. However, it does help to know the reason for chronic pain and what diseases and conditions most commonly cause it. This type of pain affects up to 1 in every 10 adults and generally most commonly associated with back-related issues, though a number of other conditions can be to blame, as well.

Chronic pain is characterized by pain that does not go away as it normally would after an episode of being sick or a specific injury. This type of pain is often described as a burning or electrical-feeling, as well as aching and/or shooting. It can be soreness, tightness, a stiff feeling or just plain uncomfortable. Symptoms of chronic pain include an inability to sleep because the pain is keeping you up at night, withdrawal from the activities of daily living, depression, an immune system that is significantly weakened, moodiness, a sense of helplessness of hopelessness, irritability and more.

However, the good news is that this type of pain doesn’t have to stop you in your tracks. There are ways to deal with, mostly starting with understanding how to manage it and what causes it. Back pain is one of the major causes of chronic pain. From spinal stenosis, which is characterized by a narrowing of the canal in the spine, to a slipped disc, there are a number of back injuries that can cause lasting pain.

Compression fractures are also contributes to chronic pain as is spinal deformities and damage to the soft tissue around the spine. Another common cause of chronic pain is headaches, brought on by excessive fatigue, stress and injuries around the neck of back. Migraine headaches are a common cause of chronic pain as are cluster headaches, which are caused by overly large blood vessels that lead into the head area. Headaches are considered to be chronic if they occur at last half the days in the month for three months at a time.

Another common cause of chronic pain is join pain, mostly related to arthritis. This is not only felt by elderly individuals, as younger people can struggle with arthritis as well. Pain signals coming right from the brain is another cause of chronic pain. This can be caused by nerves that are in the midst of a healing process, as they tend to over-fire and cause more intense feelings of pain. This can result from diabetic neuropathy, which is a common side effect of diabetes, and sciatica, which is the nerve that runs from the back all the way down to your feet. If this nerve is damaged or compressed in any way, the shooting pain that results can be downright debilitating.

Additional diseases that can cause chronic pain include cancer, in which the pain is caused by tumors that can develop just about anywhere on the body, as well as fibromyalgia, which can also cause extreme fatigue and sleeping disorders. Depression is another common cause of chronic pain, which may come as a surprise to some people to know that mental imbalances can cause this kind of pain, but this is a fact and it can be challenging to resolve without resolving the depression itself.

Chronic pain in can be managed, particularly if the cause of the pain is identified. From medicinal options to meditation and other holistic methods, there are ways to manage this pain so that it doesn’t take over your life. Pinpointing the cause and attempting to treat it is just the first step in the process. Resolving not to give up and working closely with medical professionals to reign in the pain is the best way to stay persistent in taking on this issue and winning over it.

 

Complex Regional Pain Syndrome Diagnosis and Treatment

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pain1Diagnosing and treating complex regional pain syndrome (CRPS) can be complicated, but with a team of pain specialists and experts, an accurate diagnosis and treatment plan can be achieved. The best way to diagnose this chronic condition is by ruling out other conditions, like rheumatoid arthritis, for example. By the process of elimination, a pain doctor and his team can come to the correct diagnosis.

According to WebMD, triple-phase bone scans can be used to identify changes in the bone and in blood circulation. The presence of a previous injury can be a sign of complex regional syndrome, as well as a higher-than-expected amount of pain from that injury. The Mayo Clinic points out how important your medical history is when diagnosing this condition. They also suggest the following:

  •  Bone scan – A radioactive substance injected into one of your veins permits viewing of your bones with a special camera. This procedure may show increased circulation to the joints in the affected area.
  • Sympathetic nervous system tests – These tests look for disturbances in your sympathetic nervous system. For example, thermography measures the skin temperature and blood flow of your affected and unaffected limbs. Other tests can measure the amount of sweat on both limbs. Dissimilar results can indicate complex regional pain syndrome.
  • X-rays – Loss of minerals from your bones may show up on an X-ray in later stages of the disease.
  • Magnetic resonance imaging (MRI) – Images captured by an MRI device may show a number of tissue changes.
Medication will be one form of treatment. According to WebMD, Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen (Advil, Motrin, others) and naproxen sodium (Aleve), may ease pain and inflammation. In some cases, doctors may recommend prescription medications. For example, antidepressants, such as amitriptyline, and anticonvulsants, such as gabapentin (Neurontin), are used to treat pain that originates from a damaged nerve (neuropathic pain). Corticosteroids, such as prednisone, may reduce inflammation.Pain management therapies will also be suggested to relieve your pain. Hot and cold compresses can reduce swelling and treat the temperature of the affected areas. Various creams may be used to help reduce hypersensitivity. Nerve-blocking medication may help to relieve pain, as well as transcutaneous electrical nerve stimulation (TENS) and spinal cord stimulation. Since complex regional pain syndrome seems to stem mainly from nerve damage, treating the nerves from deep within can be your best option.And, of course, physical therapy will be recommended to improve range of motion and strength. If we’ve said it once, we’ve said it a million times, staying healthy, eating right, and remaining active are truly the best medicine for many chronic conditions. Physical therapy, light yoga, and light exercise are, more often than not, going to be included in every multidisciplinary pain relief treatment.

If you have unexplained pain that might be wrongly diagnosed, speak to Dr. Pyles today.

Conditions That Benefit From Peripheral Nerve Stimulation

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face downIn addition to the general misunderstanding that often surrounds peripheral nerve stimulation as a form of pain management, there is also a lack of understanding about the types of conditions that this therapy can be used to treat. Chronic back pain is not the only condition that can benefit from peripheral nerve stimulation; there are a host of other health conditions that can offer patients relief from chronic pain and discomfort.
What is Peripheral Nerve Stimulation?
Peripheral nerve stimulation or field stimulation is characterized by the implantation of electrodes in the subcutaneous tissue surrounding the patient’s painful area. The electrodes are situated along the peripheral nerves, with the intent of controlling the pain emanating from this area. The device implanted in the body is safe and has proven to work for people for whom more traditional methods of pain management haven’t worked thus far. This is part of why peripheral nerve stimulation has become such a well-known and highly recommended form of pain management, as it is often an option of last resort that actually works for people that haven’t had success with any other form of pain management. This is also a boon for patients that don’t want to continue to take prescription medications and need to function daily without much medical intervention in the long term.
Treatable Conditions
Health conditions that may benefit from this form of treatment include: complex regional pain syndrome, diabetic neuropathy, low back and neck pain, pain following surgery from hernia (or just about any surgery that results in long-term, chronic pain, nerve injuries, peripheral neuropathies, vascular disease, intercostal neuralgia, post-amputation pain, trigeminal neuralgia and more.
However, it is important to work with a doctor that specializes in this particular form of therapy. The process will start with a trial period in which you will work closely with your physician to determine if the placement of the electrodes has helped decrease your pain. You will also work with the stimulator representative to determine what stimulation settings work best for you. During this trial period, you will be able to decide if this therapy is something that will help improve your overall daily living activities and whether or not to go forward with a permanent device. After the permanent device is implanted, you will continue to work closely with your stimulator specialist to ensure that the device is managing your pain and that you feel overall improvement.
For many, it is a chance to have their lives back. They are no longer home-bound or stuck taking strong medications that can affect their abilities to go on with activities of daily living. This is a positive benefit of peripheral nerve stimulation and can make a huge difference in the lives of those living with chronic pain.

Trial Spinal Cord Stimulation

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spinalcordinjurySpinal cord stimulation is a method of pain management that can help reduce chronic pain in many individuals. Often used as a means of treatment when it seems as though little else has or will work, this is often the measure of last resort that ends up making the difference in the lives of thousands of patients.

However, many people still do not understand how it works and what makes it so effective. Moreover, the process of getting spinal cord stimulation started remains a mystery to some, as there is a trial period associated with this procedure.

Spinal cord stimulation works through a device that sends electrical currents to the nerves in the spinal cord that are causing pain. These pulses block the receptors coming from the brain that send the pain alarms ringing. However, because there is a simple surgical procedure associated with the implantation of the device, it is always important to make sure that this method will work for the patient in question. This is where the trial process comes into play.

The completely reversible trial run allows you to experience what spinal cord stimulation feels like for about a week. During this time, you can determine how you react to the pulses, how effective they are in managing your pain and how you feel about the device, which is not implanted during this trial period. After the week is up, you will consult with your doctor again and talk about how you felt the device worked during the week. If you were happy with the level of pain management that was afforded to you via spinal cord stimulation, then you and your doctor can make plans for the permanent implant.

It is important to note that even the permanent implant is not as such; if it is not working for you any longer or you don’t want the device to be implanted, it can always be removed. The surgery to implant it, generally done in the back area, is a quick one and is often done on an outpatient basis.

Once the device is in, the patient can experiment with the different pulse levels and get a feel for what works. The patient will work one on one with the spinal cord stimulator representative to achieve the adequate coverage of their painful areas. Spinal cord stimulation is all about what makes you, as the patient, have better pain management, as this is ultimately the goal of this form of treatment.