Neuro-stimulator: The chronic pain eliminator

Millions of people, including 116 million Americans, are living each day with a pain that just won't go away. But now, doctors are zapping it away.

Some doctors believe they’ve found the answer in a gadget for patients' chronic pain.

Catherine Vonderhude suffers from chronic pain.

"It's like a thunderbolt of pain that goes across my body,” she said.

For years, Vonderhude lived each day, each hour, each minute in pain.

"Little things you would take for granted are a far reach from what you can do,” she added.

The pain started in Vonderhude's neck, and then moved to her cervical region. Due to extreme pain, she had difficulty using use her arms and was forced to give up her interior design business. She lived on pain medication and steroid shots.

One day, the pain became so intense she forgot where she was.

“I ended up in the subway yards. The motorman didn't notice I was still on the train. I had been slumped over."

Then she heard about neurostimulation to zap her pain away, altering pain signals before they reach the brain.

"It's like having an injection, except there's no medication,” said Dr. Neel Mehta of Weill Cornell Medical College. “There are wires. There's no incision, no scars."

The system is made up of a small generator and leads. The leads are attached outside the spinal cord.

The generator produces mild electrical pulses which interfere with the pain signals and replace the pain with a massaging and tingling sensation.

"It's not a cure, and it's not an antibiotic, but it has given her life back, and that's what she wanted to get her life back,” said Dr. Mehta.

Before the stimulator, Vonderhude said her pain was a10 out of 10. Today, she tells us it's a three -a number and a feeling that she thought she would never experience again.

"It's like the skies opened up for me and I knew I had a chance for the rest of my life."

The best candidates for the device have pain going into their arms, legs, back or neck.

The Neuro-stimulator can also help with things like spinal stenosis, chronic abdominal pain, and certain types of headaches.

The stimulator does not work for 10 to 20 percent of patients.

RESEARCH SUMMARY

BACKGROUND: Chronic pain can be mild or excruciating, episodic or continuous, merely inconvenient or totally incapacitating. With chronic pain, signals of pain remain active in the nervous system for weeks, months, or even years. This can take both a physical and emotional toll on a person. The most common sources of pain stem from headaches, joint pain, pain from injury, and backaches. Other kinds of chronic pain include tendinitis, sinus pain, carpal tunnel syndrome, and pain affecting specific parts of the body, such as the shoulders, pelvis, and neck. Generalized muscle or nerve pain can also develop into a chronic condition. Because of the mind-body links associated with chronic pain, effective treatment requires addressing psychological as well as physical aspects of the condition. ( Source: WebMD)
SYMPTOMS: The symptoms of chronic pain include mild to severe pain that does not go away, pain that may be described as shooting, burning, aching, or electrical, and feeling of discomfort, soreness, tightness, or stiffness. Pain is not a symptom that exists alone. Other problems associated with pain include fatigue, sleeplessness, withdrawal from activity and increased need to rest, weakened immune system, changes in mood including hopelessness, fear, depression, irritability, anxiety, and stress, and disability. (Source: www.webmd.com)
TREATMENT: Medications, acupuncture, local electrical stimulation, and brain stimulation, as well as surgery, are some treatments for chronic pain. Some physicians use placebos, which in some cases has resulted in a lessening or elimination of pain. Psychotherapy, relaxation and medication therapies, biofeedback, and behavior modification may also be employed to treat chronic pain. (Source: http://www.ninds.nih.gov)

NEW TECHNOLOGY: A neurostimulator is a surgically placed device about the size of a stopwatch. It delivers mild electrical signals to the epidural space near your spine through one or more thin wires, called leads. The electrical signals cause a tingling sensation in the area of your chronic pain. Neurostimulation provides pain relief by blocking the pain messages before they reach the brain. In other words, it outsmarts your pain. Instead of pain, you feel a tingling sensation.

You can adjust the strength and location of stimulation using a handheld programmer. For example, you can regulate different levels of stimulation at different times of the day or for various activities - such as walking, sleeping, or sitting. If your neurostimulator features AdaptiveStim(tm) technology, then it will automatically adjust stimulation when you are upright (sitting or standing), lying down, or active while in an upright position.

A complete neurostimulation system includes several components:

Neurostimulator: The device that generates the electrical impulses (usually placed under the skin in your abdomen or upper buttock).
Leads: Thin, insulated medical wires that deliver electrical pulses to the epidural space near the spine.
Physician's programmer: A computer at your doctor's office that lets your doctor adjust the neurostimulation system and its settings
Patient's programmer: A handheld device you can use at home to customize the stimulation
The neurostimulation system does not make any noise. It may be felt as a small bump under your skin, but does not normally show through your clothes. (Source: http://www.medtronic.com)

FOR MORE INFORMATION, PLEASE CONTACT:

Neel Metha, MD
(646) 962-7246
painmedicine@med.cornell.edu


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