Spinal Cord Stimulator: A Possible Solution for Complex Regional Pain Syndrome
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 delayed nerve healing. Once the MR neurographies, electodiagnostic studies, and overall health assessments have found no possible cure for the severe intractable nerve pain, then it is time to think about spinal cord stimulation, sooner rather than later.
Spinal cord stimulation is used for many types of painful conditions including failed back syndrome, phantom limb pain, and arachnoiditis. The pain control is best in the buttocks down the leg using neurostimulation. The most dramatic results can be seen in those with CRPS. Upwards of 60 percent with CRPS will respond to a spinal cord stimulator. These results translate into returning to work, using less medication, and visiting the doctor less. All in all, spinal cord stimulation can pay for itself within five years.
As usual, these good results from spinal cord stimulator therapy in CRPS can be undermined by complications that may arise. Equipment failure can happen, although not as frequently as seen with the intrathecal pump. And infections can happen with any implant. Specific complications from the SCS are lead migration. The leads that deliver the electrical stimulation may migrate down the spinal canal over time. Although annoying, this complication is remedied with a revision of lead placement and is certainly not life-threatening.
One complication that tends to happen to everyone with a neurostimulation implant to varying degrees is a foreign body reaction. The immune system tends to react to anything foreign. This complication may require the removal of the implant. Yes, some people need the spinal cord stimulators removed for various reasons. Despite these risks, someone with CRPS may find that the benefits from a spinal cord stimulator outweigh the risks.
So instead of trying a bunch of sympathetic blocks which have no medical evidence to support their on-going use, try a spinal cord stimulator if the pain from CRPS is ruining your life. But if you expect that this procedure will cure you and/or have no functional goals if you were to have better pain control, then SCS is not for you. Until an actual cure is found for you, this may be your best solution for CRPS. But don’t take my word for it, ask someone who has one.
Christina Lasich, M.D., wrote about chronic pain and osteoarthritis for HealthCentral. She is physiatrist in Grass Valley, California. She specializes in pain management and spine rehabilitation.