Advanced treatments for neuropathic pain (neuropathy)

When oral medications and/or nerve blocks do not sufficiently control the pain, advanced pain therapies or implantable systems may be effective for treating neuropathy. These systems are designed to interrupt transmission of pain signals from the spinal cord to the brain. If the neuropathic pain signals do not reach the brain, then the patient does not actually feel the pain.

  • Spinal cord stimulation (SCS) for pain control passes low levels of electricity to the back portion of the spinal cord.  This blocks the sensation of pain. The device is implanted during a surgical procedure and may include a fully implanted system or a system with an external power source.  Spinal cord stimulators may be used to manage pain from failed back surgery syndrome or radiculopathy (sciatica or leg pain). About 50 to 60 percent of patients will get a 50 percent or better pain relief with this procedure.  The pain relief has lasted up to 20 years following the implant.
  • Spinal pumps (or pain pumps) delivers pain medication (typically morphine) directly to the space around the spinal cord using an implanted pump. The pump is placed with a surgical procedure, and medication in the pump is added every month to six weeks by injecting the drug through the skin into the pump reservoir.

    Spinal pumps may be used to manage chronic pain from osteoporosis or axial pain, and sometimes may by used to manage pain from failed back surgery syndrome . Spinal pumps are also used to treat spasticity as is seen in multiple sclerosis.

    Often, multiple medications are put into the pump. That is, morphine to treat the pain and local anesthetics (such as bupivacaine) to treat neuropathic pain.

For each of the above procedures, a trial is first performed to see if it is effective and how the patient reacts before the surgery is performed. Both of the procedures are reversible and the implantable system can be removed.

Go to the next chapter on major procedures.

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Last modified: 07/27/08