Spinal Cord Stimulation for Failed Back Syndrome

Hello Dr. Lasich. This on caught my eye because after talking it up to me about how much better I would be, yadda, yadda, I had the surgery. Fusion, something was done for stenosis and bone spurs. Oh God, I wish I could go back to descison time. You can best believe I would NOT have had the surgery! Yes I was in pain and yes I had some problems but I could WALK and I could work in my garden and do things like shop, cook etc. I can't do any of thrse things now.I CAN'T walk without a walker and eventhen I can't walk very far. I have no balance and fall down a lot and, and, and. If I thought I could win I would sue te crap out this doctor. I know, bad word.But excuse me he deserves it. After he cut on me, I never saw him again. Not while I was in the hospital, not when I had my stitches out. That I could deal with, but he destroyed m life. My doctor I'm will now has mentioned the stimulator to me. That option is still option. Thanks for writing about this subjet. JoAnna

 I was going to have a stimulator put in but the Dr was told that  it may interfere with my pacemaker,sooooo Here I still am. I take narc. to releive the pain  but I guess Im getting tolerant to them. When will it end?

Please be careful before making the decision to get a spinal cord stimulator, no matter how much pain you are in.  Things can go horribly wrong, and in my case, the vendor and doctor abandoned me after overstimulating me to the point where it burst the battery pack inside of my body.  Just try to even get a surgeon to remove it if that happens, and forget ever having access to a pain doctor again.  Or any other doctor, for that matter.  These vendors have a lot of power, and if they mess up, you will be blamed, and blacklisted from ever getting treatment for pain again.  Choose your manufacturer wisely, and make sure you believe they will stand behind you should their device fail.  Then, your life, not just your pain will be on the line.  Ask who will do the implant.  I wasn't told until after a trial with excellent results, that the doctor who did the trial didn't do implants.  They split up the responsibility, so that no one will stand behind you if something goes wrong.  Then, vendors cannot be held responsible no matter what they do, as they are not medical professionals, and if they burst your battery, you are out of luck.  Before SCS, I was in pain, but could walk, and had access to adequate pain medication.  Now, I am totally bedridden, and no pain doctor will even speak to me.  I have been dumped by almost all of my doctors, because they don't know what to do about this, and are afraid of doing anything less they offend the vendors, who bring them so much money.  If you do do this, I wish you well, but remember that the actual success rate is not very high, and those who fail are in a worse position than they started.  If you have any regrets about previous surgeries, I would seriously stand back and look at this carefully before jumping into it.  I regret this surgery more than I regret any others.  This is just my experience, and yours may differ.  I hope so, as the relief I experienced during the trial was awesome.  Unfortunately, the implant never gave me any relief, and has only increased my pain and disability.

I had a spinal stimulator surgically placed in my back over one year ago.  It has been very effective.  My pain level has been reduced by approximately 50 to 80%.  I have also been able to reduce the amount of pain relief drugs that I've been on for over 5 years.  I've seen the pain management surgeon about every three months to consult and check how I've been doing with the device.  A representative from the company that manufactures the device has met with me every time I've visited the surgeon and remains on call 24-7.  There is risk of having it done.  I'm one of the luck ones that have had success with the procedure.   

Hello,

 

I have been following spinal cord stimulation for two plus years now and have done much research on it's use and of course I read with great interest what anyone has to day about it.

 

One thing that I will say to those that have had horrible experiences with this or any other treatment or feel wronged by who provides these services for you that we do have a process that is called ligitation and that is something you have to decide on depending on the circumstances.  The process is in place and it does work well so you are never without options, you have many and if you were to consider this I would seek out the advice of the best counsel and they are out there to help.  I do empathize with your plights tremendously but again will say you do have options and remedies available to you if you choose to do that.

 

I am quite fortunate in many ways, I have a team of hand picked specialists that I can get along well with and get along with me.  It was not easy to assemble my team but they are most definitely keepers and I would personally accept no less than the best.  I do everything to a large hospital and cluster around that.  A good hospital like the one I have will not tolerate anything but the best physicans or other medical providers.

 

Within my team, I have a terrific pain management specialist who is board certified in pain management and board certified in anesthesiology and he does take very good care of me and has since I met him and added him.  He is one that I would never ever trade, he does take care of my pain. 

 

I too have been very cautious about the use of spinal cord stimulation because yes, there are risks and that was about the second thing that came out of my pain management specialist's mouth when he first mentioned it to me years ago.  It is an intrusive procedure and having an opioid pump implanted is also invasive so I have sat back, gathered data but have stayed with medication therapy for my pain as well as other techniques.

 

My pain management specialist and I actually discussed spinal cord stimulation yesterday and he tends to be somewhat on the conservative side with how he provides his services which is another thing I like about him. 

 

I am one of the ones that could probably benefit the most from spinal cord stimulation because my intractable pain is basically in my legs and feet which seem to do much better than any other part of the body that has pain if spinal cord stimulation is used.  I have intractable pain and I have two disorders that will never go away, one being a lymphatic disorder and the other a nerve disorder so I am fortunate in many ways and these will not affect my longevity....I will just have many, many years of pain to deal with.  There are so many more that are worse than I am, I just have pain, not fun by any means but still I do consider myself to be very fortunate because I know what is out there and that most have much more to deal with than I do.  

 

My PM specialist (if I abbreviated it to PMS it could take another meaning and be confusing) chooses very few for spinal cord stimulation but because of my personal factors, I am one that is in that chosen group so in a way I guess I am lucky or maybe not however I am still in the thinking stage right now.  I might do the trial, I am still not sure but when I decide to if I decide too it will be with the best information I can find and I do listen to everyone and look at everything the best I can.  Because of the two types of disorders that I have (a disease is totally different than a disorder) I would have about an 80%  chance of success if I were to have SCS.

 

I am in no hurry to try SCS or an opioid pump, I suppose it all is about if my pain bothers me to the point where I can't deal with it anymore using the methods I currently use then I might consider it even more.  I stay with one pain medication in both continuous release and immediate release at all times and always will have to do that.  If I can continue to get the 70% total pain relief that I get now which is a great target number in PM I am doing good.  I do supplement with other things for my pain as far as medications and the more you mix in there the better your results though I only use one type of narcotic.  I know all of my limits on what I do take and stay within those windows....information is truly the key.  After medications my next best PM method is distraction.  The more I can distract myself in the ways that I choose is also very helpful to manage my pain.

 

Should you care to make any comments to what I have written or give me more information that would be good, I learn new things everyday from different sources and that is how we do learn or at least how I learn.

 

I wish the very best to everyone that might read this and my wish, though very unrealistic is that everyone be pain free.  Of couse that is not the reality of things but I at least hope that you can be as pain free as possible and that you can find the best doctors as I have because they are such a key partner to me and it is a partnership.

 

Try to have a good day if you can and I say it that way because I know some cannot and I do understand that as well, sometimes I wish I had a magical answer but I do not, I struggle with the same things that you do.

 

Randy. 

I HAVE THE SPINAL CORD STIMULATION FOR MY LOWER BACK AND MY NECK AREA FOR ABOUT 10 YEARS AND OVERALL IT HAS HELP ME ATLEAST 50 PERCENT. MY NECK AREA WORK LOT BETTER THAN THE LOWER BACK ONE AND IF I HAD IT ALL OVER AGAIN I WOULD. DORSEY

One of my doctors has repeatedly suggested that I get a SCS. I have talked to several people who have one and a majority of them say that it has helped them relieve 50-80% of their pain. My problem is that this doctor will not consider implanting one until the pt has been off of all narcotics for a minimum of 3 months. Well, if I could do that I woudn't need s SCS. His statement is that the narcotics block the nerve receptors for at least 3 months so it messes up the true responses during the trial. My view is " If you hit me with a hammer for 3 months, when you stop I'm going to say, "Yes, that feels better." I don't feel that anyone should have to suffer for 3 months before being helped. I would have to take 3 months off of work and lie around the house. I can't afford to take 3 months off of work before I have to take approximately 6 weeks off after the SCS is placed. Now, when he sees me, he just shakes his head. I say he isn't giving me any plausible options. I have heard others say they didn't have to stop their pain meds at all before the SCS is placed so I know that I could go to another doctor but I live in an area where there is limited options. He is the only one in the area who implants SCS. For me, right now, I will continue to manage my pain pharmaceutically.

I had both this and morphine injector implants suggested for my back pain.  I had two operations and then years later ended up with a major lumbar infection and abcess involving the branch nerves and spinal cord.

 

I have so much scared tissue and damage that the neurosurgen recommended that I have no other implants or operations unless I have another life threatening event that requires my back to be opened up.  Until then, I am on pain patches and tablets for breakthrough pain.

 

I have learned to deal with the pain within reason.  If these treatments can help someone they should consider them.  But, be sure that the benefits out way the additional risk of another surgery.

I  had 2 failed back surgeries in 203/04 that left me with a totally compressed sciatic nerve and constant lower back pain. It  has been 24/7 non-stop pain since then, I live a daily 10 pain scale, and for me that is  great, I have never been lower than an 8.

  in 2006 I had  a morphine pump implanted after trying all options, P.T., Accupuncture, Chiro, the worst part is I am allergic to just about every pain drug out there, I mean the kind of allergy that I convulse, tongue swells, etc., so not normal hives type of allergies.  I am 5' and weight 100 lbs., the  1st pump they implanted was a 40cc one after I requested a small one, after 3 mths. it became detached, the surgeon was a real creep and told me to deal with it, so I had to  find another surgeon. During this time I came down with a full blown attack of RSD, my feet and lower legs were just about black, swelled like tree trunks, finally  the skin split open and they started to leak which led to open sores that took months of treatment to heal, needless to say if anyone has rsd they know it never leaves, there is no cure, it does go into remission for short periods of time, but every time your body suffers a drama it brings on an attack. It is a horribly painful disease.

  I am now on my  3rd pump as of Sept., now they think the cathera has a leak because I at certain periods of the day get so high I can't see and just pass out cold for anywhere  10 min. to an ht., so I have had it with the pump because I have never gone below a 10 pain scale and that also included earing 6 10mg. Endocet and 4 5mg. Percocet, 3 10 mg. Valium a day, now this has been for 5 years straight!!! Immediately after the surgery is when I started this passing out so I literally cold turkeyed  the oral meds, what a night mare, but of course the pain increases, they have decreased my meds in pump by 20 mg. total to see if that woukld stop the crashing and it  has, but the pain is  out of control, I am able to eat 3-4 5 mg. of percocet a day but that is the limit because I then start to nod, so obviously  there is a problem.

  As far as the stimulators go, I also have severe scoliosis both forwards and to the left, so it is basically impossible for them to put them in me, also the fact that my bones are so thin they are almost transluesent, I can actually break a rib by pressing too hard on it, sad no, especially for a 58 year old who not quite 6 years ago had a career and was active and is now 95% housebound.  I just wish these dr.s's would be more up front, because I have so many problems and most of them are on the rare side, no one wants to take me on, it is like ipening a can of worms!!! Between the 1st and 2nd pump iyt took me 20 surgeons before I could get one to see me, none of them wanted another dr.'s mess, when the 2nd one saw me the  fisrt thing he said was Who the hell butchered you like that?!!  He did a fantastic job, but when problems arose with that pump he would not place a third in, he refused, he felt my body just did not want one in there.

  So any suggestions as to any other paths there might be for me?  I know it is doubtful, but figured I would just ask.

Thanks for listening

AnnMarie   

I am now a 57 yr. old mom of 5 (now college students,and grad.s) kids.I worked as landscaper with my wish for doing and teaching sculpture to be posponed untill Kids independence allowed.I had terrible lower back pain in 93' which led to an attempt to use a tens unit 1st to see if dorsal column stimulator would be effective.This was not done in a hospital but a Dr.s office and I developed an infection in my spine which led to an emergency surgery while my youngest was only 3 (now 18). I recovered,ended a bad marrige and gained responsibility of 5 as single parent.Pain was tolerable to work as house cleaner till I could complete landscape degree.I loved the work but by o3' my hands were swelling and I felt more exhaustion,however,my back seemed ok. I was then found to be HCV positive when my  liver enzymes were tested due to multiple joint site pain.I now have suffered and paid for a spinal laminectomy for spinal stenosis that was to resolve the lower lumbar pain.I have seen so many experts,even Mayo clinic in Florida has been less than helpfull.I now have a seronegative RA diagnosis,hcv wich won't allow any of the nsiad or most ra med.s to be used.I also contracted lymes after7 yrs.landscaping I get it just wishfully looking around my overgrown garden.I am amazed at how badley treated I have been by Dr.s who see my use of narcotics as the issue and the illness as not worth their time to help me navigate through. I am seeing a very bright ,compassionate pain specialist at Rutland Regional Med. Center who has been very successfull with helping people suffering from chronic pain.Pain alone has severe side effects. One becomes anti social  because you make your peers,children or those waiting in line next to you uncomfortable by facial,or discomforting body motion you are not aware you are making.I do not like what narcotics "do" to my life drive,personal capabilities,nor the way some health care specialists reaction to my "addiction". If only they could be given the same options I have for just 48 hrs. I find myself vacillating between wanting to withdraw from the pain buffers and Dr.'s offices and bills,and hurt my family horribly by ending my life,to keep on trying to resolve some of the areas of pain which I have been doing since 03' .I cannot tolerate Doctoral bad attitudes,along with my constant and sometimes way over my head  pain.DO any of these practitioners get held accountable for the damage they do so self rightously?The pain specialist I now see ,won me over by saying his 1st priority is to do no harm.He is trying to help me establish a stronger pain tolerence level with ketamine injections.His hope,as mine is,Iwill suffer less and be able to cut back on the short rope of narcotic use.I really don't understand all the pain specialists out there with the attitude of their potential greatness if only their patients weren't so awful.

Thank you Dr. Lasich, for a great post!  It is so nice to hear about options out there, that it seems no one else wants to tell us about!  For some reason we don't seem to get to many options or choices when it comes to working as a team to help manage our chronic pain.  The treatment we do get is horrendous.  I am so tired of being treated like I should just take a few motrin and "suck it up".  My favorite is, "lets just try another injection over here, cause this might work better".  Please, the last 20 haven't worked! 

It has been great to hear everyone's opinions on the stimulator.  As we all know, there are always risks with any procedure. So I guess we need to hear the good and the bad and decide for ourselves if it's worth the risk or not. Surgery has been good for some and terrible for others.  My ACL sugery and my low back fusions have been awesome.  My neck fusions, not so good! So whatever anyone decides, it has to be where you are at that time.  I know for myself personally. I am at my wits end.  I do not want anymore surgery and I am willing to try just about anything at this time. I am doing so much research on everything, so that when I go to my Doctor, I will be armed with everything I got!  If he won't allow me to be part of my treatment.  Then I will just keep moving on!!!  It has taken me 10 years to finally feel entitled to this.  I know there are compassionte, wonderful Doctors out there, and I plan to find me one of them.

Much luck to all of you in your struggles to find some comfort in your lives!  Let's keep fighting, we deserve it!

 

Lisa

 

Lisa