A Powerful Tool for Pain Control: Neurostimulation

Think about your 10 closest friends and/or relatives. Is any one of them in pain today? One out of every 10 Americans suffers from chronic (long-lasting) pain of some type. Have you ever wondered why that person doesn’t just get over it? Scientists, researchers, and pain experts are actively seeking to find out how to break the pain cycle — or even prevent it from starting in the first place.

This article looks at one way to stop chronic pain: neurostimulation. Neurostimulation involves the application of electric current near or along the nerve pathways causing the pain. The idea may seem barbaric at first. In fact, according to stone carvings, it was probably used thousands of years ago. Fish that emit electric currents were applied to people to treat headaches and arthritis pain.

Today, the electrical stimulation is applied in a more technological fashion — but it still amounts to sending an electric impulse either to or through the spinal nerves, spinal cord, or brain. The idea is to override the pain messages that seem to have gotten stuck in the on setting. The idea of neurostimulation is currently in use for conditions like migraine headaches, back pain, post-operative pain, phantom limb pain after limb amputation, and even angina that won’t go away.

How is it applied? There are several different by which electrical stimulation can be delivered. The first and easiest method is called peripheral nerve stimulation (PNS). Flat, surface electrodes (square, round, or rectangular shaped) are placed over the skin over the area of pain or near the affected nerve. A small handheld device is connected to the electrodes that can be set to deliver low-level electrical impulses through the electrodes. The little box can be attached to a belt for ease of use.

A second method is called percutaneous implantation. The peripheral nerve stimulator is actually placed under the skin. This works best for patients with low back, head, neck, and/or facial pain because the implant can get close to the spinal nerve roots causing the problem.

When peripheral nerve stimulation doesn’t work, then spinal cord stimulation is considered. Spinal cord stimulation is used most often for severe, constant back or limb pain that isn’t relieved by any other means (e.g., medications, peripheral nerve stimulation, physical therapy, nerve blocks). The unit is implanted into the spinal canal where it can relay electrical impulses to the brain through the spinal cord.

A third method directly to the brain is called motor cortex stimulation or deep brain stimulation depending on where the implant is located. These implantable devices generate a low-voltage electrical pulse that blocks the brain’s ability to perceive and register pain. These units are battery powered and have multiple settings that allow the patient to choose different intensities, patterns, and duration of stimulation. They can even be turned off and back on to vary the input and try to override or fool the brain.

There are some cases where neurostimulation of this kind cannot be used. That includes anyone with a pacemaker or defibrillator for the heart, a systemic infection, and/or pregnant women or nursing mothers. Sometimes exceptions can be made for the patients with a pacemaker, defibrillator, during pregnancy or while nursing. But the systemic infection is always considered an absolute contraindication (no-no) for neurostim.

For those who might benefit from neurostimulation to treat chronic pain, it’s a trial and error sort of process to find the best choice for each patient. Two people with the exact problem may not respond the same to equal treatment. It can be a very frustrating experience for the affected individual. But with a little patience and some time, it is often possible to achieve a successful outcome.

Of course, chronic pain has other affects mentally and emotionally that may require some attention, too. Neurostimulation is just one of many tools used in a comprehensive pain management plan. It has the advantages of being reversible, safe, and cost-effective. Best of all, the use of medications are not required and patients taking pain relievers are often able to reduce the dosage and number of pills required. Sometimes, it’s even possible to get off all medications with the use of neurostimulation. Many patients find that a great boon to this form of treatment.