Most patients with chronic pain find a resolution with one of the nonsurgical methods. However, there are a handful of patients who reach this level of care for relieving their pain, because everything else has failed. The following techniques offer very potent pain management and, for some patients, they offer the only solution for pain control.
Intraspinal pump is a device that delivers a constant level of pain medication directly into the intrathecal space, which is the space right near the spinal cord that contains the cerebrospinal fluid. With a minor surgical procedure, a catheter can be inserted and left in the intrathecal space of the spinal canal, attached to an external pump that pumps the pain medication into the body at a predetermined rate. The drugs used are often some combination of an opioid, the alpha-agonist clonidine, a local anesthetic, and a muscle relaxant. The advantage of these implants is that the medication is being delivered directly to the area of pain rather than having to travel throughout the body, and therefore the patient will require much smaller doses of medication.
Spinal cord stimulators deliver pulses of electricity to the spinal cord. They can be considered a more aggressive form of TENS, useful for patients who don’t respond well enough to TENS. The electrodes of the device are permanently implanted near the spinal cord. The procedure is either done through the skin or by an open surgical procedure. The leads are then connected to an implanted radio frequency (RF) controlled receiver or to an implanted pulse generator (IPG) that supplies power to the electrodes. When non-painful electric pulses from the spinal cord stimulator flood the nerves, they decrease the pain felt by the person. Because these implants are self-contained, patients can resume doing all their daily activities, including bathing and swimming.
Chino, Allan F. & Davis, Corinne D. Validate Your Pain! Bloomington, IA: AuthorHouse, 2004.
Cochran, Robert T. Understanding Chronic Pain: A Doctor Talks to His Patients. Franklin, TN: Providence Publishing, 2004.
Dillard, James N. The Chronic Pain Solution: Your Personal Path to Pain Relief. New York, NY: Bantam Book, 2002.
This page was first published on May, 15th, 2008 and was last updated on May, 21th, 2008