Bluetooth-controlled stimulation for pain control

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Researchers at the University of California San Diego are coming to the rescue of people with terrible pain in one part of their body.

They're using a stimulator that goes directly on the dorsal root ganglion, a bundle of nerves that transmit pain signals to the brain.

Raul Silva had his leg amputated in San Diego after a motorcycle crash in Mexico.

"I lost my leg years ago, in 2000. Since then, I have phantom pain," he said.

That is, his leg is gone, but he felt cold, numbness and terrible pain where it once was.

He worked to support his family for a while but had to stop. Then, his doctor told him about a new pain control system called dorsal root ganglion stimulation, or DRG, made exclusively by Abbott.

"The dorsal root ganglion is an offshoot of your spinal cord that correlates to a very specific nerves that's coming from your spinal cord to your specific extremity or portion of your back," assistant clinical professor of anesthesiology and pain medicine Dr. Krishnan Chakravarthy said.

Raul did a seven-day trial with a temporary device sending electrical pulses to block pain signals to the brain.

"The analogy I give is if you have a six-lane highway or a bunch of cars that are driving, we're effectively setting a roadblock across the highway," Chakravarthy said.

After 17 years of suffering, Raul reported his pain was gone.

"It was amazing because for instance, the beginning, I feel like a real amputee person, no pain, no phantom pain, no cramping, nothing like that," he said.

Raul became UC San Diego Health's patient No. 1 for the permanent DRG stimulator. The leads and battery are implanted, and he controls the intensity and location of the stimulation with this bluetooth device. He says the system is giving him his life back.

In a randomized trial, 74 percent of patients reported meaningful pain relief, compared to 53 percent who got standard dorsal column spinal cord stimulation.

The DRG stimulator is Food and Drug Administration-approved. The system costs around $25,000 but can be as much as $40,000, which can be covered by insurance.

To learn more about Abbott’s DRG therapy, visit aboutyourpain.com

MEDICAL BREAKTHROUGHS
RESEARCH SUMMARY
TOPIC: BLUETOOTH DRG PAIN CONTROL
REPORT: MB #4561

BACKGROUND: Phantom pain occurs when people experience a neuropathic pain from a limb that is no longer there. This means that the nervous system has malfunctioned. It affects 50 to 80 percent of amputees regardless of gender, age or size. Raul Silva broke his femur in a motorcycle accident, and his leg got infected by gangrene in the hospital in Mexicali, Mexico. The gangrene was so bad that the amputation was done in San Diego. People who have lost a foot or leg experience the pain the most. It usually comes within the first week after amputation, but it could be delayed and begin months after. If someone experiences residual limb pain, abnormal growth on damaged nerve endings, or pain before the amputation, that could lead to phantom pain. Symptoms include pain coming and going or the pain being stabbing, cramping, throbbing or burning. (Source: https://www.myvmc.com/diseases/phantom-limb-pain/ https://www.mayoclinic.org/diseases-conditions/phantom-pain/symptoms-causes/syc-20376272)

TREATMENTS: Some patients do not need treatment, as the pain improves over time; for others, doctors can prescribe antidepressants, muscle relaxants, anticonvulsants or beta blockers to help. There are also other options that focus on the brain and spinal cord. Mirror box has patients look at mirror which makes them believe the limb is still there, and they perform exercises with the existing limb to help them imagine that the missing limb is the one moving. Other non-medication therapies include acupuncture and spinal cord stimulation. (Source: https://www.mayoclinic.org/diseases-conditions/phantom-pain/diagnosis-treatment/drc-20376278 https://www.amputee-coalition.org/limb-loss-resource-center/resources-for-pain-management/managing-phantom-pain/)

NEW TECHNOLOGY: There is a new device to stop the pain signals from going to the brain through the DRG. Dorsal Root Ganglion, or DRG, contains sensory neurons that bring information to the spinal cord. The device by UC San Diego is implanted into the patient's back to send out mild electrical pulses and is controlled by a Bluetooth. The device is also compatible with MRIs. The device does not need to be recharged because it uses a large single charge battery. Dr. Krishnan Chakravarty says that the difference between the DRG and spinal cord stimulation is the localization. The DRG targets the specific area that is in pain instead of the whole spinal cord. There is also a new clinical trial that is looking to use augmented reality and superimposed limbs that move the lost limb and end the pain inside. (Source: https://www.medicalnewstoday.com/articles/273130.php https://ucsdnews.ucsd.edu/pressrelease/uc_san_diego_health_offers_new_bluetooth_enabled_pacemaker_for_chronic_focal_nerve_pain)