The implantation of a medullary stimulator is a technique used to treat chronic neuropathic pain. The technique requires implanting electrodes in the epidural space and the rest of the device (performing electrical stimulation) with its battery is implanted under the skin.
Why does pain relieve a spinal cord stimulator?
As the mechanisms involved in pain relief are studied, it is discovered that it has a greater complexity than previously thought.
As for neuropathic pain, there is a part that functions as a TENS does, occupying the nerve channels and closing the door to painful stimuli. It is now also known that GABA (gamma aminobutyric acid) systems are altered in the dorsal area of the bone marrow. On the other hand, part of the pain relief seems to come from its effects at the brain level. The explanation for the efficacy of pain is not clear at all. Increasing complexity seems to be discovered with mechanisms that affect the central nervous system and explain how certain long-term effects are maintained after withdrawal of stimuli.
These stimulators are also used in ischemic pain. This is the pain that occurs when blood does not reach an area of the body. The mechanism of pain relief here goes another way, producing effects on the blood vessels through stimulation of the sympathetic system.
Who benefits from spinal cord stimulation?
It should be made clear that it is a treatment for chronic pain that has not been managed otherwise. In the case of the back, these stimulators are being put in patients who after surgeries have not improved and are very affected by a neuropathic pain that does not stop.
Sanitary systems are as they are and solutions to back problems are posed from a “do me” point of view. We begin with conservative treatments, which consist of taking medication, carry girdle and be treated by a physiotherapist, for example. If this fails the next step is invasive treatments whose final step is surgery. As you can see there is little education and intervention in the patient’s way of life. Of the people who are operating there is a small percentage that goes from intervention in intervention to ending a chronic pain for which the surgeon can no longer offer a solution. This person ends up in a pain unit and, among other possible treatments, these stimulators are used. This is the most common case of back injury that ends up using a spinal cord stimulator. This web I developed to open the mind to analyze all the aspects of our life that can be changed to improve the situation of our back. The goal of everyone should be that less and less people come to this situation that we have commented.
These stimulators are also used in other types of diseases but are not related to the back.
Is spinal stimulation effective?
Not all types of chronic back pain will benefit from a stimulator. The pains radiated from the legs due to irritation of the nerve roots will be the ones that will improve with more probability. Back pains are purely more complex and less effective in this type of pain.
A very important factor is the degree of psychological involvement in chronic pain. In people with high levels of depression, anxiety and somatization will have little benefit from such a technique. Keep in mind that it is an invasive treatment and should be limited to people who have a chance of improving without complications. In this sense also have to take into account other medical problems such as the use of pacemakers or coagulation problems.
The medullary stimulator is most successfully implanted when chronic pain takes relatively little time. If we have been with pain for ten years, implantation is less likely to be a therapeutic success.
Can I have an MRI if I have a spinal cord stimulator?
The answer is that it depends on the device. You must follow the manufacturer’s instructions because there are some that are compatible with magnetic resonance imaging and others that are not. When in doubt, if you do not know, you should not perform this test.
In summary, the medullary stimulator is an alternative to control chronic pain. It is a palliative measure of suffering that does not cure the injury although it can greatly improve our quality of life. You have to choose the patient very well that can benefit to make it a success. We must take into account that it is an invasive treatment and that we carry an electronic device implanted in our body communicating with the epidural space. This has risks and adds more reason to use it strictly when it is necessary and studying the patient well.