Most of us have heard of steroid injections for pain which is one treatment available for chronic or acute pain. But according to Dr. Mansoor Aman, an interventional pain management physician at Aurora Health Center – Oshkosh, there have been several recent breakthroughs that are lesser known.
Dr. Aman explains that chronic pain that lasts greater than three months is different from acute pain after an injury or surgery. There is often “central sensitization” in which pain is encoded by the brain and you continue to experience pain even though your imaging tests don’t show any injury or inflammation. Doctors can use nerve stimulator devices to reduce your pain from these painful stimuli.
Nerve stimulation offers different advantages depending on where the lead is placed. Stimulation is often felt as a massage-like sensation. Sometimes it runs in the background without any sensation at all.
To make sure the right spot has been identified, your doctor will usually start by inserting a temporary lead. This also helps you learn how to use the controls of the unit to choose different patterns and levels of stimulation. After you and your doctor are both satisfied that it’s helpful in reducing your pain or increasing function, the temporary unit will be removed and a permanent one will be implanted.
There are three relatively new types of nerve stimulation:
- Dorsal root ganglion spinal cord stimulation: Stimulator leads are implanted near the spinal nerves at an important target in pain processing (the dorsal root ganglion). Some indications for using this method include complex regional pain syndrome, post-surgical pain or neuropathy.
- Spinal cord stimulation: Stimulator leads are implanted near the spinal column and can target a large area in the body (for example the entire lower back and both legs). The newest indication is painful diabetic neuropathy. Other conditions that may benefit from spinal cord stimulation are persistent post-surgical syndrome (PSPS), complex regional pain syndrome (CRPS) and lumbar radiculopathy.
- Peripheral nerve stimulation (PNS): Stimulator leads are placed at a named nerve that is responsible for carrying pain to a specific area. They are implanted just under the skin. Common targets are the suprascapular nerve for shoulder pain, the saphenous nerve for knee or ankle pain, or the sciatic nerve for foot and ankle pain. This method can be offered as a 60-day treatment that provides sustained relief post-treatment or as an implanted permanent option.
In addition to the newer types of muscle stimulation, there are three relatively new procedures used to treat pain:
- Minimally invasive lumbar decompression: Useful for back and leg pain, this procedure uses a tiny incision to remove tissue that is pressing on nerves and causing pain.
- VIAdisc allograft intradiscal injection: Injects a proprietary strain of cells into a damaged disc in your back to stimulate new growth that repairs the disc.
- Intracept procedure: Uses a specialized tool to deliver radiofrequency energy to treat the basivertebral nerve and block pain in your back.
“These methods are providing new opportunities for long-lasting pain relief for millions of people,” says Dr. Aman.
Advantages of these new interventional pain management treatments:
- Not addictive
- Can be done in a doctor’s office or as an outpatient procedure
- Can be done repeatedly, providing long-term relief
- Little to no recovery time needed and few complications
- Good option for people who aren’t good candidates for surgery
- Usually less expensive than open surgery
- Treatments are often covered by Medicare or insurance
While no single treatment is guaranteed to provide the relief you need, Dr. Aman says that interventional pain procedures work well for both chronic pain that may have lasted for years and acute pain that is expected to be short-lived, such as after an operation or after an injury that is still healing.
This article originally appeared on health enews.