Our nerves are our communication network. The spinal cord and peripheral nerves send pain signals to the brain, travelling along their own designated highway of nerve cells, called neurons. Altering the intensity or path of these pain signals with a treatment called neuromodulation can significantly impact patients’ chronic pain.
This type of treatment uses small – usually barely perceptible – electrical stimulation to interrupt and mitigate pain signals as they travel from the site of the pain to the brain.
Neuromodulation is like putting on noise-canceling headphones - for pain! It is targeted to treat regular pain; patients will still feel potentially life-saving pain, such as from a heart attack, touching a hot stove, or stepping on a sharp stone.
Neuromodulation has been available since the 1960s, however, the technology has advanced rapidly in the last few years, allowing for smaller devices and wireless connectivity. The treatment is better than highly addictive opioids and other medications, which can cause side effects and/or cumulative damage to organs, especially if a patient has other health issues.
How it Works
Patients first undergo a trial of neuromodulation to make sure it is effective. This is done by placing a tiny soft electrode lead, a thin wire, under the skin using a needle. If the treatment trial is successful, the soft lead is removed, and permanent leads and a small battery, called a pulse generator, are implanted into a small pouch inside the abdomen during a minimally invasive procedure.
During the treatment, a low-grade electrical pulse from the generator is activated by the patient using a remote control outside the body. The pulse passes to the lead and on to the affected nerve to modulate the pain. The remote control allows the patient to control the pulses.
Three Treatment Options
Types of neuromodulation include:
Spinal Cord Stimulation: The electrode leads are placed in the epidural space in the patient’s back, just outside the spinal cord. This is traditionally used for large areas of pain, such as in the back, neck, or legs, and as a treatment for post-surgical pain or sciatica.
Dorsal Root Ganglion Stimulation: The electrode leads are implanted at the dorsal root ganglion, a bundle of sensory nerves near the base of the spinal nerve that communicate with specific areas of the body. DRGS is more focused than spinal cord stimulation. It can be used for specific areas of the body, including the chest, abdomen, lower abdomen, or groin, or in a hand, foot, or knee.
Peripheral Nerve Simulation: This treatment is hyper-local; the electrode leads can be implanted anywhere in the body directly at the source of pain. This can be used to treat very focal neuropathic pain that can cause burning, numbness, and weakness in the legs, arms, hands, and feet. It is also helpful in treating patients who cannot tolerate sedation, because the treatment is very close to the skin and can be used with local anesthetics.
Neuromodulation causes little to no side effects, and it offers a significant decrease or elimination in the need for pain medications. Patients may also experience a reduction in blood pressure and anxiety, as well as an improvement in their mood once pain is eased. Technological advances have made neuromodulation a choice for more patients seeking an effective, non-pharmacological tool to treat their chronic pain.
Dr. Goldstein is a board-certified pain management and physical medicine/rehabilitation specialist with an office in Hackensack. He completed fellowship training in Interventional Pain Management and is certified by the Accreditation Council for Graduate Medical Education. To learn more or to schedule an appointment with Dr. Goldstein, call 201-645-4336 or visit his website