Pain Management

1. TENS units (transcutaneous electrical nerve stimulation) and Percutaneous Neuromodulation Units (PENS) work by delivering low level electrical stimulation through electrodes placed directly on the skin of the affected area. The electrical stimulation delivered through the skin may help alleviate pain by blocking pain messages being sent to the brain. Both systems require a physician prescription but this therapy can provide a convenient means of treating some forms of pain. Both are non-invasive and can be an economical solution.
2. Implanted Drug Delivery Systems (IDDS), also known as Intrathecal Analgesia Therapy, refers to the administration of medicine, either pain-relieving or spasticity-relieving, such as baclofen, by a medication delivery pump. The IDDS include a chamber or reservoir for the drug that delivers the medication through a catheter directly into the spinal canal (intrathecal). The pump needs to be refilled, usually once every few months, by placing a needle through the skin. This procedure is typically performed on an outpatient basis or during a regular doctor’s visit. Generally, a person first undergoes a trial of the medication by an intrathecal injection. If successful, a pump system can be implanted permanently through a surgical procedure. IDDS reduce the need for oral medications, can be more effective and is now a mainstay of therapy for intractable pain including neuropathic pain and spasticity.
3. Spinal Cord Stimulation (SCS) system is a hybrid system comprised of implanted electrodes in the spine and an external control unit. It uses electrical stimulation to block the pain pathways to the brain that travel through the spinal cord. SCS has also been known to decrease spasticity. An initial trial is needed to see if effective results can be achieved. If the trial is successful, a permanent system may be implanted. The user has the ability to keep the system on permanently or as needed. Find a SCS specialist in your area is provided by our partner, Neuromodec, click here to search.

Special appreciate to Dr. Elliot Krames, MD, International Neuromodulaton Society and Dr. Thomas Keller, MD, Pacific Pain Treatment Centers for their contribution creating this introduction

• Neuropathy Neuropathic pain arises from nerve injury, as the INS describes in this overview about this chronic condition that lasts from months to years. A Fact Sheet of a further description of Neuropathy; courtesy of INS
• Neuropathic Pain Since the 1980s, neurostimulation has been an option for controlling symptoms of chronic neuropathic pain, and use of the therapy continues to spread as the technology itself advances. A Fact Sheet of a further description of Neuropathic Pain; courtesy of INS
• Painful Peripheral Neuropathy The INS explains this condition as “a common neurological disorder characterized by numbness, weakness, tingling and pain, often starting in the hands or feet”. A Fact Sheet of a further description of Peripheral Neuropathy; courtesy of INS
• Complex regional pain syndrome (CRPS) The key symptom of CRPS is continuous, intense pain out of proportion to the severity of the injury, which gets worse rather than better over time. CRPS most often affects one of the arms, legs, hands, or feet. Typical features include dramatic changes in the color and temperature of the skin over the affected limb or body part, accompanied by intense burning pain, skin sensitivity, sweating, and swelling. A Fact Sheet of a further description of CRPS; courtesy of NINDS