Spinal cord stimulation is increasing in usage as a form of treatment for CRPS. CRPS is characterized by extreme pain that is caused by damaged nerves effecting an adverse reaction in the central nervous system. Spinal cord stimulation works by subjecting the central nervous system to low levels of electrical current which block the pain.
Spinal Cord Stimulation Surgery
Spinal cord stimulation is administered by an electrotherapeutic device that must be surgically implanted into the patient’s body. The surgery to implant the stimulation device generally takes about one to two hours, and the patient is under anesthesia during the process. The surgeon must make a cut either on the abdomen or buttocks, and then place the device inside of the body. Wires transmit the signal from the device directly to the spinal cord, which are placed by making small incisions on the spine and connecting to the device. A handheld remote is controlled by patients to deliver the electronic stimulation when it is necessary.
Spinal Cord Stimulation Considerations
Not every patient that suffers from CRPS benefits from spinal cord stimulation. Prior to implanting the more permanent generator, physicians typically place a temporary electrode in a more minor surgery. This electrode will provide similar electronic waves as a permanent generator, and patients will be asked to rate the level of relief from pain that is experienced. If the patient experiences a 50 to 70 percent decrease in pain, the patient may be a candidate for spinal cord stimulation on a more permanent basis.
Spinal Cord Stimulation Benefits
Spinal cord stimulation often provides more relief than other forms of treatment for CRPS. Spinal cord stimulation targets the central nervous system, so pain is stopped from reaching the central nervous system, rather than attempting to stop the pain at the source. Since much of the pain experienced by CRPS patients originates from complications within the central nervous system, this method can be much more effective than pain relief that is administered in other ways.
Results of Effective Treatment
Many CRPS patients become incapacitated due to the constant and severe pain that is being experienced. While a cure has not been found, effective methods of treating the pain may help CRPS patients to regain quality of life. Patients may be able to resume hobbies, daily care, and in some cases recommence job duties after beginning spinal cord stimulation therapy. The level of independence that can be achieved by effectively reducing or eliminating CRPS pain can also be beneficial to a patient’s mental health.
Spinal Cord Stimulation Risks
Surgery to implant the spinal cord stimulation device is not without risks. Since wires must be placed along the spine, there is the risk that cerebral spinal fluid will leak out during the surgery. This can cause pain, headaches, and nausea, but will usually subside relatively quickly following the surgery. Full recovery from the surgery can take up to a few months, during which time patients are advised to avoid heavy lifting, housework, yard work, and many other normal daily activities. Patients must receive follow up surgeries to replace batteries every several years, which can also carry risks.
Risks that may be a concern following surgery to implant a spinal cord stimulation device include:
- Reactions to anesthesia
- Rejection of the device by the body
- Paralysis caused by spinal cord trauma
- Machine malfunction
- Pain at the site of the device or wires
- Allergic reactions to device or materials used during surgery
- Battery failure or leakage
- Excessive scar tissue formation reducing effectiveness
Spinal Cord Stimulation for CRPS
Prior to discussing spinal cord stimulation as a treatment method for CRPS, physicians and patients should attempt to treat the condition using less evasive means. If other treatment methods have not been successful and the patient’s quality of life is decreasing, spinal cord stimulation may be an effective option. Patients and physicians should discuss all the risks and benefits of spinal cord stimulation and the surgery to implement the treatment before making the decision to move forward.
Shrivastav, M, and S Musley. “Spinal Cord Stimulation for Chronic Regional Pain Syndrome.” PubMed. October (2009): 2033-2036. Web. 9 Mar. 2014. <http://www.ncbi.nlm.nih.gov/pubmed/19964771>.
“Spinal Cord Stimulation.” Medline Plus. U.S. National Library of Medicine, 26 Feb 2014. Web. 9 Mar 2014. <http://www.nlm.nih.gov/medlineplus/ency/article/007560.htm>.
Theodore, Grabow, and Tella Prabhav. “Spinal Cord Stimulation for Complex Regional Pain Syndrome: An Evidence-Based Medicine Review of the Literature.” Clinical Journal of Pain. 19(6). (2003): 371-383. Web. 9 Mar. 2014. <http://rsds.org/pdfsall/grabow_et_al.pdf>.