Harvard Health Publishing wrote that “ Chronic pain is an enigma for both pain doctors and their patients: difficult to understand (as everyone’s pain is different), challenging to treat effectively, and frustrating to live with. Desperate patients sometimes turn to drastic and irreversible surgical procedures, like amputating nerves to relieve pain, and unfortunately even those procedures may fail to provide the hoped-for results.”
Fortunately there have been great strides in research related to pain perception and our nervous system’s reaction to various pain treatments, and we’ve been able to develop novel devices that provide many people with much-needed relief and improve their quality of life.
Neuromodulation is “the alteration of nerve activity through targeted delivery of a stimulus, such as electrical stimulation or chemical agents, to specific neurological sites in the body.” Dr. Norman Shealy, a neurosurgeon, implanted the first device for the relief of intractable pain in 1967, and his work ushered in a new era for chronic pain management.
One of the most common examples of neuromodulation is the use of spinal cord stimulation (SCS) for chronic pain management. SCS consists of a very thin lead (or wire) that is placed in the space just outside the spinal cord (known as the epidural space). The lead is attached to a small generator device that is implanted under the skin and subcutaneous layer in the back or buttock. The devices will deliver frequent, low-voltage electrical impulses to the spine, with subsequent modulation of the pain signals in transit to the brain. Those impulses often feel like a gentle tingling or buzzing (which is called paresthesia) on the body.
Harvard explain that another form of neuromodulation is the intrathecal pump, which is a device designed to deliver a desired medication directly into the spinal fluid surrounding the spinal cord.
Neuromodulation treatments have typically been offered to patients only after they have tried conventional treatment options such as medications, physical and occupational therapy, or surgery. Although the treatment is not without risks it is a cost affective option for managing chronic pain, in particular after failed surgery,
Guy’s & St. Thomas’ NHS Hospital in London have a Chronic Pain Management & Neuromodulation Centre. It is internationally recognised as a centre of clinical and academic excellence in the management of chronic pain.
They have a long history of providing traditional chronic pain management treatments such as day case procedures and outpatient treatments.
They have also established world prominence in the fields of spinal cord stimulation and other neuromodulation techniques, as well as in addressing the psychological, physical and social impacts of chronic pain with our pain management programmes. This is delivered through the INPUT pain management department.
The centre collaborates closely with spinal surgeons in the assessment and treatment of spinal pains, and similarly provides highly specialised, multidisciplinary assessments for conditions including chronic headache, facial pain and pelvic pain.