DRG Stimulation For Focal Pain
Some pain problems are widespread while others are more focused. For focal, chronic pain, DRG stimulation may be the best option. The DRG, or dorsal root ganglion, is a collection of nerves that sit just outside the spinal cord and relay sensation to the spinal cord and brain. Stimulating those nerves has been shown to relieve specific focal pain syndromes and is superior to many other therapies. Examples of focal pain are pain after hernia repair, post-herpetic neuralgia (pain after shingles), pain after limb amputation, pain after joint replacement and CRPS (complex regional pain syndrome or RSD). DRG stimulation is very similar to spinal cord stimulation. Before going to DRG stimulation we will evaluate you to ensure that you have tried more conservative treatments and that DRG stimulation can be done safely. To determine if DRG stimulation is the right choice we may need further imaging or consultations. Initially DRG stimulation is done as a temporary trial that we liken to test driving a car. The trial or “test drive” allows you to be certain that DRG stimulation will give you good pain relief before doing anything permanent and is done at the outpatient surgery center. DRG stimulation uses special electrodes that are designed to go next to the DRG. One to four electrodes are placed in the epidural space using X-ray guidance and sedation. We connect them to an external pulse generator and you get to try out the device for 3-7 days. We will ask you to keep track of your pain during the trial and you determine how much benefit you get from the device. At the end of the trial we will remove the leads. If you obtained good relief then you will be scheduled for a permanent device implant, also done at the surgery center and with anesthesia. All the permanent components are placed under the skin, similar to a pacemaker.