Wednesday, May 22, 2013

Spinal Cord Stimulator: A Possible Solution for Complex Regional Pain Syndrome

By Christina Lasich, MD, Health Pro Monday, August 15, 2011
Until a cure is found, solutions to help someone live with pain are the next best thing. Complex Regional Pain Syndrome (CRPS) is one such condition that may not be curable, but it can be made livable. Before CRPS is declared incurable, doctors must look for a reason for ongoing nerve injury or delay...
8/18/11 7:26am

I have CRPS over 18 years and with the SCS my life has turned around.I was walking with 2 canes plus using a wheelchair to get around and lots of medications.With the SCS no more canes,wheelchair,and no more meds.I would recommend it very highly.I have CRPS in my right hand and arm,shoulders,back,and both legs and feet.

8/18/11 8:03am

I was first tried on a trial for one brand , which was not successful. The next unit  was. it lasted for about 5 years with one revision. It had been a preety good unit needing adjustments..It was taken out last year,due to some irritation.I have learned alot on this journey we are embarking on when it comes to the everyday horror of living with such suffering. I now use some pain and nerve meds and dry needling a massage. Thanks.

8/18/11 11:46am

Could you share with us the one that did not help I have had 2 the first a Medtronics and now a Boston Scientific.

8/20/11 5:19am

]UndecidedSorry, entered at the wrong time. 

Anyway, how long was the recovery.  Was there pain after the surgery * how soon or how long did it last.  How often did you need adjustments.  Do you have wires that need to be run outside the body, so you can adjust the pain relief?  How does that work, regarding something coming outside your body, Is it attached to you somehow, to your clothing....is there chances of infection?  Does it get in the way of regular living.  Sorry for all the questions, I'm just very hesitate for some reason.  Does it relieve fibro pain * headaches, things like that.  Anything you can share would be great.  Thanks for the assist.  Glad you are doing well after the new unit(s) were applied.  How long did it take to replace one unit with another?  You can either answer me here or email me directly @ angelsher57@gmail.com Thanks for the assist.  god bless Smile Sherry

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8/21/11 3:55am
Hi Sherry, I saw your post and I wanted to give you my experience with a spinal cord stimulator. First off, I was diagnosed with RSD in 1999 from a horse accident. It originated in my left leg but within a couple of years the pain had spread to both my legs & hands. I had a stimulator implanted in 2005 and it was amazing, the simulation helped right away with my pain. If you do a trial implant first, then only the leads (wires) are implanted into the epidural space, then the wires will connect outside the skin to an external battery pack. My trial lasted 2 days. For the permanent implant everything is implanted under the skin including the wires & the battery. The surgery itself was fairly painful since you are awake for most of it so that your doctor & the stimulator representative can make sure that the leads are along the right nerves. My recovery was pretty easy & my rep had my stimulator programmed the day of my surgery,so most of my pain was severely diminished. It takes a little bit of time to get use to the constant feel of stimulation in your legs & you have to work with your rep to get good programming coverage, which can take multiple visits. Unfortunately, my battery kept trying to push its way out of my skin. After several revisions we discovered that I am allergic to the stainless steel & titanium of the battery, so in Dec 2007, I had to have the stimulator removed. My plan was to re-implant a new stimulator with a battery covered in paraffin. But during that surgery it was discovered that there was too much scar tissue built up in the epidural space to implant the new leads. If I had known that this would be the outcome I would seriously go through revisions every 2-3 months just to have a stimulator, it was that helpful. My advice to anyone thinking of having an implant is to have allergy testing done first. My doctor contacted the company rep, mine was a Boston Scientific & she sent an allergy testing kit with all of the pieces parts & I just went to an allergist. After me, my doctor has had like 4 or 5 others with allergies so everyone now gets tested first. I know that I have written a book here but let me answer one last question. I also have fibromyalgia & migraines; but since my stimulator was only for my legs I didn't really notice too much help for either. After having no luck with Botox or daily & acute meds for my migraines, which average 4-5 days a week, I am now going to have a supraorbital stimulator implanted in my head, above my right eye for my migraines. The wires run behind the ear & down to the shoulder area where the battery will be implanted. This battery will be encased in paraffin. My trial will be within the next month. I will let you all know how it goes. If you have further questions email me at lisamariekehl@cox.net & I will be happy to answer any questions. LisaMarie
Anonymous
phil h.
8/18/11 1:22pm

     I had mine implanted Sept 2010;  surgery recovery was long and painful, particularly where control unit was implanted in butt.  Five weeks after implant, programming was started and continued almost monthly for 5-6 months.  But no signal ever was able to reach my real pain spot , my right shin, St. Jude rep said it might be a "dead zone" and that no signal would ever reach it, not exactly what i wanted to hear because this is why it was implanted in the first place.

       Then after almost six months of programming by 3-4 different programmers, programs started to become inoperable.  Programmer did some testing and said 3 of the 12 contacts which gave the electrical stimulation to my spinal nerves had broken so that they were sending no signal at all.  The programmer tried to program around this and left me with only two programs which now operate and are slightly helpful.

     Remedy is to replace everything, which means another painful and slow recovery time operation by the neurosurgeon who did the first implant.  He says if this one does not work out, I'm at the end of possible remedies, and will be stuck where I am, and will probably continue to note gradual pain level increases, what a wonderful prognosis!

     Another thing, I actually felt better with meds before the implant, i think the implant itself did some more spinal nerve damage, and now I am on more pain meds, narcotics, than ever before, so BUYER BEWARE, it is not all peaches and cream as you are lead to believe from the St. Jude Medical DVD and printed sales material.

    FYI, my pain was caused by failed back surgery syndrone, (FBSS).  No one should ever let a surgeon cut on his spine unless it is the VERY LAST resort.  I learned that the hard way, and rue the day in 1999 that I decided so let a orthopedic surgeon perform a laminectomy to stop pain in my R leg caused by spinal stenosis.  While the laminectomy temporarily stopped the R leg pain, the surgeon nicked another nerve and I woke up from the surgery with L leg pain which was twice as bad as the R leg pain the laminectomy was supposed to cure.  I has been downhill since then. phil h.

8/19/11 7:40am

I too had a stim implanted approx 2 yrs ago. I suffer  from Failed back syndrome and neve damage from being struck by a car as a child some 45 yrs ago. The stim helps slow down leg pain, but does Nothing for my lower back pain. After 3 procedures and all other pain mgmt methods,I am left with facing the fact that i will use a cane,a scooter,and do very few of my fav activities from this point forth. I,too,rue the day in Dec 2008 when i allowde my First Back surgery-L4-L5-S1 fusion!!!

8/20/11 5:32am

I'm soo sorry to hear about your battle. That's why Im checking with folks who have hit done.  For some reason, I'm hesitate about this surgery;.  Have had several others with no hesitations, but I'm scared of this one.  I'm post lamentomy, disk laying on my sciatic nerve causing such unbelievable pain in my right leg.  The surgery was successful, but still having low back pain, problems with pain in both calves * sometimes but & thighs as well.  Currently severly anemic * low white blood cell count.. They want to schedule the trial asap, like next week.  Scared of wires coming out of my body * chance of infection or disconnection, I fall often * have lots of problems with sleep tossing & turning.  Not sure to follow thru or not.  Just went to ER tonight due to weakness from anemia, migraine, low back & leg/calve pain, with pressure abcesses on both ankles.  Just starting to heal after 2 weeks.  HURT like heck.  Don't know about the implant * PAIN from fibro, DDD, osteopenia, etc. 
Thank for anything you can feel like sharing would be helpful.  You can respond to thisor email me directly @ angelsher57@gmail.com.  Thank you so much, God Bless.  Will pray your pain condition improves.  SherryUndecided



8/22/11 11:29am

Hello there... I'm sorry for your all of your health problems and I feel your pain... I'd be hesitant, too...  You need to ask your doctor about getting iron infusions and make sure that they test your B-12....  It can cause so many problems, such as falling and pain, as well as many other things that are not reversible if not treated in time....  Read up on B-12 deficiency and I'll bet that you'll recognize a lot of symptoms...  B-12 shots are an easy fix or you can get the sub-lingual drops and not have to deal with any needles...  I'd have the doctor check all of your B's, as well as your D....  These should be standard blood tests that doctors perform, but sadly enough they don't....  Keep a copy of your lap reports so you can see how the levels fluctuate, as well....  The United States has some of the lowest normal levels that I've seen... So, you may have low iron or B-12 but your test shows that they're within normal limits... The normal levels for B-12 are between 200-900, but you can start having symptoms when yours gets to 400 or lower... Sometimes, iron def. can go hand in hand with B-12 def....  When I read that you fall a lot, a light-bulb went on...  That was me a few years back...  My feet would just seem to come out from under me or if I tripped, I couldn't balance myself back up-right....  As far as that stimulator goes, I'd be interested if it helped my back, as well as my muscle knots and aches...  Right now I am going through my second round of Radio Frequency Lesioning....  Last year, I had both sides of my lower back and both sacroiliac joints done and I had good results with the exception of the left sacroiliac....  Something went wrong there and my skin got extremely sensitve to the touch, which got better with time...  But all in all, the RFL did well enough last year to do it again, so...  I wish you all the luck in the world and just know that you aren't alone...  A lot of us are going through the same daily painful journeys... And while I wouldn't wish anything bad on anyone, it's nice to know that others understand my plight because those who are well, (family and friends) are not always understanding and not willing to read up and educate themselves... Hearing, "but you look well to me" gets in my craw...  lol  Have a good one and if you need to ask any questions, my email addy is homeisala@yahoo.com and my name is Sheri....  Take care...

9/21/11 5:15pm

This is my 1st day reading this site.  I was an olympic gymnast in 1968.  I developed spondylolesthesis when I was 18 from all of the overarching required for the sport which ultimately ended my career.  I was bothered off and on throughout my life with pain, but it came back with a vengeance 4 years ago.  I have had 5 back surgeries. To make a very long story short surgery # 3 was to completely redo surgeries #1 and 2 because I developed pseudarthrosis, (failed fusion).  The doctor redid the fusion of S-1 thru L-3.  10 days later when I tightened my stomach and buttocks my sacrum fractured.  The doctor then had to put in two 4" screws in my sacrum.  I work up in surgical intensive care because the pain was so out of control.  I would fight not to cry out, (athletes do not cry or complain), every time they would turn me to look at the dressing.  After many tests they found that there were bone chips on the sciatic nerve therefore requiring surgery #5.  It has been exactly a year.  It was a very long recovery and in July and August with the medications things were looking up.  I forgot to mention I am on oxycontin 20mg twice a day and percocet 10-325 up to 4 a day for break through pain.  I was actually was taking less awhile back until 3 weeks ago.  Now the back pain is getting far worse again and the leg pain too.  The good positive attitude I had is slipping away.  My pain management doctor is wonderful!  He has talked about the spinal cord stimulator, but is not pushing it.  After all the hell I have been through the idea of them going back in there is just not acceptable.  Today is miserable and just a reminder of what life was like until 6 months ago.  I feel frightened because I can't endure that all again and neither can my husband.  And if anybody else says, "But you look so good," I'll smack them.  Also even though I don't know it for sure, I feel the looks from people when they hear about the drugs I am taking.  Anyway I have been reading about the spinal cord stimulator and frankly it just scares me!  I think I am in a bad place right now.  Was the gymnastics worth it?  I've been wondering this for a very long time now.

9/22/11 4:22pm

Competitive gymnastics is very hard on a spine and aging gymnists like yourself do feel the effects. Many professional or seriously competitive athletes live with chronic pain as they get older and that tends to tarnish the good memories.

 

Although I am not exactly clear about where your pain is coming from, I am assuming that because of the nerve damage that you have some degree of nerve pain down the leg or both legs. Nerve pain is tricky to treat. I usually approach it with a combination of drugs that specifically address nerve pain like methadone, Lyrica, Neurontin, and desipramine. One medication that you might have tried already is a very good alternative to oxycodone products. This medication is called Nucynta. Its unique mechanism of action lends itself to treating nerve pain in a far more effective way than other standard opioids like oxycodone, fentanyl, or morphine. Not to sound pitchy, but talk to your doctor about it.

 

Nucynta has impressed me with its ability to control nerve pain like phantom pain, complex regional pain syndrome, neuropathy and the like.

 

If your doctor really has not explored other medication options, then it is probably premature to jump onto the SCS wagon without a second opinion.

 

Hope this ray of hope brighens your day a bit and removes some tarnish from your memories.

 

Dr. Christina Lasich, MD

Anonymous
Really Tall Redhead
8/18/11 8:45pm

Tomarrow, 8/19/11 I get my spinal cord stimulator "installed". Its hard to wrap my head around the fact that I may not have this never ending foot and leg pain every waking, and non waking moment of my life. I almost cant remember what it was like to get out of bed, maybe use the restroom, walk into the kitchen, feed the cats, without contimplating my every move and where I will stop along the way, or what I will grab onto to steady myself....I'll keep you posted. THe trial went wonderfully, even had a pedicure...

Anonymous
Really Tall Redhead
8/20/11 5:06am

Surgery was successful. Im more achey than super pain.Cant really bend to much,but rested when I got home, even made dinner, took a while but I did it. I am using a walker , which really helps. Using Robaxin for the sever muscle pain. And some percocet.Funny, though I dont really notice the foot and leg pain....

My CRPS was caused by a injury when I fell, torn achilles, twisted ankle, slight foot fracture. Podiatrist just attributed it to my neuropathy, till I did some research, and it was determined what I really had.

Anyway, Today is the 19th, I go into the Surgeons ofc Aug. 25 to get it programed by the St. Jude Rep. He says his wife has this very same model, and has been doing well with it for several years.

Im very hopeful.

I must have a positive mental attitide, I need to get back to living a somewhat normal life.

Will keep you posted..

9/22/11 10:03am

so how is it going now? are you glad that you had it done?

Please comment

Anonymous
Really Tall Redhead
9/26/11 9:50pm

Cant believe its been just a wee bit over a month now since the implant surgery. I was actually moving around pretty well a few days after everything. The spot where I had the incision hurt more than the feet, which I imagine is typical since no one likes having staples in their back. I would say, within 2 weeks, the incision area pain was completely gone. As for the foot and lower leg pain... 95 % GONE GONE GONE GONE GONE....DID I MENTION....DONT HAVE IT !!!!! This is no BS,  truly, gone. I am going to Physicl Therapy, to help strengthen my feet/leg muscles, etc. I walked "Funny" for so long, favored the way I walked, Im retraining myself to walk correctly again. I feel the "buzzy" feeling, which is no big deal really. My device has a few different programs, so I can adjust it. I have recharged the device a few times, which is really easy...they show you all of that stuff.

I am a true believer in this thing!! ST JUDES IS THE MAKER OF THIS DEVICE, THEY ARE AWESOME I CANT SAY ENOUGH GOOD THINGS ABOUT THEM...THEY HAVE BEEN WITH ME EVERY STEP OF THE WAY. Every doctor appt. etc...

9/27/11 1:56pm

I am happy for you. I hope it will take care of your problem for ever. Best to you thank you for you comment. I have a lot of thinking to do.

Painfulanne

 

Anonymous
Really Tall Redhead
9/27/11 6:41pm

The device is bringing me back to life Ann, I dont want to go back to the way it was before. Think of the possibilities it will allow you to do again. Im 48, Im not ready to hand in the towel, I feel like I can finally think of the future. I have my moments when its still a challenge, dont get me wrong, but just imagine how good you just might feel.

Take care of yourself, walk carefully, and G-d Bless you and keep you safe.

Romy

8/23/11 12:06pm

This is all the pain center wants to do to me, I don't want it, I have been told by 3 other Doctors not to do it. They have not heard anything good about it from other paients.  I just don't know what to do any more. I am in so much pain daily and all night every night. Its has been 6 years since my 1st spinal surgery My second one was in 2008. The pain has gotten worse everytime.  I just need something to do this pain if it wasn't so bad maybe I could go with out crying everyday. Any idea of what I could do? any comments?

Anonymous
phil h.
8/23/11 3:26pm

implanted morphine pump is only other alternative.

9/22/11 9:58am

I'm sorry I never got back to you sooner. thank you for your comment. They do want to take the hardware out, well maybe. Its been over  1 1/2 month since I was at the doctors and haven't heard anything, they were going to make the appointments. I have left many messages but no call backs. so I'm doing what I can. Theres a nerosurgen in Rochester I may go see. I was told that the pain etc. maybe cause of the body is rejecting the hardware. I don't know anymore. what would be good to do anymore. my pain has gotten much worse to were I can't breath cause of the pain. or breathing is causing more pain. I don't know what to do anymore. The pain over comes everything. As we all know. I guess I have alot of thinking to do. All take care and feel better.  Chris 

9/28/11 1:08pm

I had one of these implanted about 7-8 years ago. At my pain clinic it was a relatively new trial device. The factory rep was on hand to see how it went. They put the leads in while I was 'asleep' then woke me up so they could adjust the lead so it hit the correct nerve and would stop the pain in my foot. Then put me back to sleep to finish. I had the electric 'jolt' contoller on the out side of my body so I could control the amount of stimulation. I had a severe problem with "lead migration" as stated in the article. Every time I moved it moved around and then when I went to use it I would get a jolt on the wrong area of my foot/leg. It was incredibley painful! I lasted 3 1/2 weeks with it in me. After that I told the dr. that if they didn't take it out I would yank it out (which is basicaly what they did anyway). The pain when they took it out was so immediate and intense that I vomited. At that point I elected to go off all meds and any blocks just to see if the SCS would have helped when it did hit the right nerve and it did to some degree. 6 weeks later I had to ask for a Lumbar Block and went back on meds. I really wish it would have worked for me. I could have worked and brought in much more money to our household but as it is I get depressed knowing I can only work so much that the amount I bring in is minimal.

 

9/29/11 12:20pm

Hi Skydiver,  Did they just take it out in there office? It sounds like the pain center I go to. They just care for people who just shut up and take the drugs.  I mainly want the pain to go away its now 7 years and its just getting worse. it now hurts to breath.  Also its been 2 months now that there were going to make an appointment for a Doctor to remove the hardware and scar tissue. No answers from why they haven't done it yet. They never call back. I just don't know what to do.  In Nov. I'm going to a new doctor but in Rochester 1 1/2 to 2 hr. ride. If he can help i will deal with the ride.  I hope your doing well now. Best to you.

painfulanne

Anonymous
Really Tall Redhead
9/29/11 5:52pm

What ever it takes to get relief is what you need to work with.  I didnt really have the option of taking drugs/narcotic pain relievers. I am a diabetic so I already come with kidney issues. Some times I take so many meds, I get full. Last thing I needed was one more pill going through my poor kidneys. I used to slather lidocain on my feet and lower legs, and strap ice packs to my feet and the area, then take an ambien to get to sleep. I became sleep deprived if I didnt do this, the pain was so great I could never sleep.  So far, here it is Sept. 29, 40 days out from my surgery, and still no problems, you posted,  I will say many prayers for your comfort and relief.

9/29/11 8:27pm

Hi really tall redhead, thank you for all your replys it means alot to me. At least I know someone is listening. Unlike the doctors. 

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By Christina Lasich, MD, Health Pro— Last Modified: 10/23/11, First Published: 08/15/11