Spinal Cord Stimulator, a ray of hope for those suffering from damaged Spinal nerves and Spinal Cord

We have all heard of  cardiac pacemaker  and how it can revive a critically and  irreversibly damaged heart by  generating electrical impulses called cardiac impulses or action potentials required for proper pumping of heart thus acting as a true life savior in otherwise hopeless condition. Quite similar to it is, spinal cord stimulator, a device used to exert pulsed electrical signals to revive the already damaged spinal cord peripheral nerves of the patient when everything else has failed,thus giving relief from chronic pain.

Approved by the FDA in 1989, spinal cord stimulation (SCS), a form of neuro stimulation technology has over the years become a standard treatment for patients with chronic pain in their back and or limbs and those who have not found pain relief from other treatments. Spinal cord stimulation (SCS) is a pain relief technique that delivers a low-voltage electrical current continuously to the spinal cord to block the sensation of pain.

Spinal cord stimulation (SCS) in the simplest form, involves stimulating electrodes implanted in the epidural space, an electrical pulse generator implanted in the lower abdominal area or gluteal region with the conducting wires connecting the electrodes to the generator, and the generator remote control. As pain changes or improves, stimulation can be adjusted as necessary.

Most patients who qualify for neurostimulation therapy report a 70 to 90% reduction in overall pain, as well as an increased ability to participate in normal family and work activities. Many patients find that they can decrease or stop taking painkillers or other pain medications after undergoing spinal cord stimulation. Given these benefits, there has been ongoing research and advances in spinal cord stimulation technology, and many individuals suffering from chronic pain find that neurostimulation positively impacts the quality of their lives. However, it is important to note that the degree of pain relief experienced from spinal cord stimulation or peripheral nerve stimulation varies from person to person.

In general, neurostimulation works by applying an electrical current to the source of chronic pain. SCS is the most commonly used implantable neurostimulation technology for management of pain syndromes. As many as 50,000 neurostimulators are implanted worldwide every year. SCS is a widely accepted treatment for chronic pain of the trunk and limbs (back, legs and arms). It has notable analgesic properties and therefore also used  for treatment of failed back surgery syndrome (FBSS)  spinal cord injury (SCI),nerve damage and in the case of motor Neuron damage.

Spinal Cord Stimulation is a measure of last resort and generally helps in reducing the chronic pain the patients might be suffering,thus giving him or her a chance to have better quality life.

Irregular back pain;get examined for Spinal Stenosis

                                               Watch out against irregular back pain-It might be Spinal Stenosis

Spinal pain is one of the major health problem being faced by the people. Young or old,office goer or blue colared worker,all are affected by the pain,with the type and severity being the only differentiators. One such pain,is Spinal Stenosis,a problem which occurs when bulging discs, arthritic spurs, and thickened tissues combine to compress the nerves traveling through the spinal cana .Most commonly seen so far in the elderly, a disturbingly high number of youngsters have recently been started being diagnosed with this problem. It was known to be commonly caused by wear-and-tear changes in the spine related to aging but in youngsters life style issues are playing a major role.

In Spinal Stenosis, the open spaces within the spine (backbone) gets narrowed which causes pressure on the spinal cord and nerves. The narrowing process, which is gradual, reduces the space available for the spinal cord and nerves. In most cases, the narrowing of the spine is associated with stenosis which ultimately compresses the nerve root. It may cause leg pain, numbness, tingling and weakness in body.

Spinal stenosis can be difficult to diagnose because its symptoms can be caused by other conditions. Usually, people who develop stenosis have no history of back problems or any recent injury. It symptoms generally includes irregular pain which goes away on resting.The pain is pronounced while walking.The condition is caused by years of wear and tear and not generally by sudden injury.

There are two types of spinal stenosis lumbar stenosis and cervical stenosis and unless and until very severe and complicated,it can be non surgically treated.It is important for the patient to be physically active and exercises may not cure but play a major role in quicker recovery. Change in daily activity like using a recliner instead of strait jacketed back seat are other important measures which can be taken.

Another treatment which works in about fifty percent of the cases is set of epidural injection.These have a further role as those require surgery,the one’s who have taken these injections have quicker and better recovery.If despite all these measures the patient continues to suffer from debilitating pain,then surgery is one such good option.Infact the result of the surgery in the case of Stenosis is second only to removal of Herniated discs.But there are due considerations which should be taken care of before the surgery and only best of the surgeons who is very sure of his craft should undertake it.

The surgeon should be sure of damaged stenosis.No other nerve should be pinched during the surgery.Also the physical condition of the patient should be considered before hand.If such precautions are undertaken the surgeries are generally safe and lead to good outcomes for the patients.   

After the surgery, pain may persist for a few days, requiring the use of pain medications and inflammatory drugs to reduce swelling. Walking and strengthening exercises will be prescribed for the lower back and abdomen which will help stabilizing the spine. Hot showers and hot compresses or the use of an ice pack also will help removing pain.

Watch out against irregular back pain-It might be Spinal Stenosis

Spinal pain is one of the major health problem being faced by the people. Young or old,office goer or blue colared worker,all are affected by the pain,with the type and severity being the only differentiators. One such pain, is Spinal Stenosis,a problem which occurs when bulging discs, arthritic spurs, and thickened tissues combine to compress the nerves traveling through the spinal cana.

In Spinal Stenosis, the open spaces within the spine (backbone) gets narrowed which causes pressure on the spinal cord and nerves. The narrowing process, which is gradual, reduces the space available for the spinal cord and nerves. In most cases, the narrowing of the spine is associated with stenosis which ultimately compresses the nerve root. It may cause leg pain, numbness, tingling and weakness in body.

Spinal stenosis symptoms generally includes irregular pain which goes away on resting.The pain is pronounced while walking.The condition is caused by years of wear and tear and not generally by sudden injury.

There are two types of spinal stenosis lumbar stenosis and cervical stenosis and unless and until very severe and complicated,it can be non surgically treated. It is important for the patient to be physically active and exercises may not cure but play a major role in quicker recovery. Change in daily activities like using a recliner instead of strait jacketed back seat are other important measures which can be taken.

Another treatment which works in about fifty percent of the cases is set of epidural injection.These have a further role as those require surgery, the one’s who have taken these injections have quicker and better recovery. If despite all these measures the patient continues to suffer from debilitating pain, then surgery is one such good option. In fact the result of the surgery in the case of Stenosis is second only to removal of Herniated discs. But there are due considerations which should be taken care of before the surgery and only best of the surgeons who is very sure of his craft should undertake it.

The surgeon should be sure of damaged stenosis. No other nerve should be pinched during the surgery. Also the physical condition of the patient should be considered before hand. If such precautions are undertaken the surgeries are generally safe and lead to good outcomes for the patients.   

After the surgery, pain may persist for a few days, requiring the use of pain medications and inflammatory drugs to reduce swelling. Walking and strengthening exercises will be prescribed for the lower back and abdomen which will help stabilizing the spine. Hot showers and hot compresses or the use of an ice pack also will help removing pain.

Radio Frequency Neurotomy- a new ray of hope for people suffering from long standing spinal pain

Incidence of Musculoskeletal  disorders are increasing, with a lot of people being diagnosed with ailments like osteoarthritis, rheumatoid arthritis, cervical, spinal stenosis etc. But despite the awareness about these diseases, little information  is available on their possible cures and that too the latest one. Conventional treatment involves use of physiotherapy, pain killers and if no relief ultimately surgery. Adding to the Doctors arsenal is, Radio frequency neurotomy, a form of treatment which  can provide almost magical relief from the acute pain.

A little about our Spine and how it functions

Our spine is made up of 24 bones known as vertebrae ,which are stacked into a column. Between each vertebra lies a cushiony part called disc which acts as a shockabsorber. Each vertebra has two sets of bony knobs that meet each other. The point where they meet each other is called the facet joint. These Facet joints are responsible for motion of bending, flexing (flex forward or extend backward) and twisting (from side to side). These Facet Joints are protected by soft tissue consisting of synovial fluid which acts as a lubricant between these joints. A layer of thick white cartilage covers the joint, helping it to glide smoothly when the body moves. Over the time due to ageing/injuries, this cartilage gets damaged or gets worn out. Inflammation of these joints leads to what we know as Arthritis. A number of spinal conditions such as osteoarthritis and spinal stenosis, or from an injury to the back, such as caused in car accident, all lead to facet joint pain.

Treatment for Spinal pains

Generally, the first line of treatment for such disorders involves medicines to relieve the pain depending upon the condition of the patient. But today, a new state of the art technique using radiofrequency has emerged to treat difficult and long standing spinal pain. 

A radiofrequency neurotomy is a simple  day care minimally  invasive non surgical procedure where the patient can go home the same day. Radiofrequency waves are electromagnetic waves which travel at the speed of light, or 186,000 miles per second (300,000 km/s). In this procedure, Radiofrequency Energy (a type of heat energy) is created by a special generator at very high or super high frequencies. With the use of this specialized generator, heat energy is created and delivered with precision to target nerves that carry pain impulses to brain. It involves numbing of the skin and tissue over the procedure site with an injection of local anesthetic. Next, the physician uses x-ray guidance, to direct a special radiofrequency needle alongside the medial nerves. Often, a small amount of electrical current is carefully passed through the needle to assure it is next to the target nerve and a safe distance from other nerves. This current briefly recreates the usual pain and cause a muscle twitch in the back. Then the targeted nerves are numbed with a local anesthetic to minimize pain. 

At this stage radiofrequency waves are introduced to heat the tip of the needle and a heat lesion is created on the nerve to disrupt the nerve's ability to send pain signals to the brain. 

 There are two primary types of radiofrequency treatment: A medial branch neurotomy (ablation), this  affects the nerves carrying pain from the facet joints. Another one is a lateral branch neurotomy (ablation), this affects nerves that carry pain from the sacroiliac joints.

Radiofrequency neurotomy responds well to multiple chronic pain conditions such as spinal arthritis (spondylosis), facetogenic low back pain, spinal stenosis, grade I spondylolysis, post-traumatic pain (whiplash), cervical spine , pain after spine surgery, failed back surgery syndrome(FBSS), and other spinal pain conditions. It also works well in certain neuropathic pain conditions (like Complex Regional Pain Syndrome), and some other assorted chronic pain conditions. A patient’s candidacy for this treatment is usually determined by the performance of a Diagnostic Nerve Block.

Radiofrequency neurotomy offers significant and long lasting pain relief as compared to steroid injections. Almost all patients undergoing this procedure will experience significant pain relief for a long period of time so that many patients often find a long term remission or cure for their back or neck pain. All remaining patients will also get some pain relief but for a shorter period of time. As a general rule, if effective, the ablation will often provide pain relief lasting at least 24 months and often for longer period which is very significant as patient is relieved of acute pain which no other procedure is able to provide.

This procedure being less complicated & minimally invasive without any open surgery, provides low morbidity rates, appreciable pain relief compared to surgery, greater range of motion, lower use of analgesics, improved quality of life, and short recovery time.

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