Can an Implant Relieve Chronic Back Pain?

By ABC News

Oct 14, 2013 12:22pm

ABC News’ Juju Chang, Anna Wild and Sandra Lee report:

Maria Tricoli, of Virginia, said she’s enjoying playing with her three children and being free of pain for the first time in five years.

Chronic back pain — which she described as “gnawing, sometimes burning, sometimes stabbing it can stop me in my tracks” — had previously kept her from everyday activities, such as cooking and cleaning for her family.

She and a slew of doctors tried multiple treatments, including massage and herbal medicine.

“I saw more than 27 specialists …  I must have done physical therapy six separate times in a course of five years. I have tried holistic acupuncture several times,” she said.

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In 2010, when her back pain began to turn her arm cold and blue, Tricoli, 37, said she was forced to give up her job.

“For the first time in my life I felt like I was not in control. The pain kind of controlled me,” she said.

Finally, Tricoli saw a doctor who suggested a spinal cord stimulator — a device surgically implanted near a person’s spine designed to send electrical pulses to the spinal cord. In theory, these electrical pulses interfere with the nerve impulses that make you feel pain.

The stimulator has been around for decades, but, with doctors moving away from the use of painkillers, newer, technically improved devices are in demand for patients suffering from chronic back pain.

“I think spinal cord stimulation is an excellent option, especially for people who have failed all other therapy,” said Dr. Nader Pouratian, director of neuromodulation and associate professor of neurosurgery at the David Geffen School of Medicine at UCLA.

Because it’s an experimental model, Tricoli got her spinal cord stimulator for free, but many doctors are concerned that $35,000 is a lot to pay for a surgery. Every surgery comes with risks, and medical experts say there are still serious questions about the device’s long-term effectiveness.

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In fact, some doctors believe the pain relief may come from a powerful placebo effect.

“We found in our study and others that patients continued to take narcotic pain killers even after they have had this type of device implanted, and the literature suggests that benefits tend to wear off after six months to a year,” said Dr. Richard Deyo, a professor of family medicine at Oregon Health and Science University.

But after two months, Tricoli said the implant has given her a new lease on life.

“Just to not be in pain is a blessing, to be a part of my kids’ lives, to go to the playground with them, I never was able to do that before” she said.

Spine specialists that ABC News consulted say they’ve seen some success for some of their patients with the device, but they generally recommend trying it only after unsuccessful repeated attempts to treat chronic pain through conventional exercise and cognitive behavioral therapy. ABC News also heard from Medtronic, one of the makers of the device, who said spinal cord stimulation is a proven therapeutic approach for managing chronic pain that is not effectively controlled with conventional treatments.

It’s clear more research is needed on who can benefit most, and chronic back pain sufferers are encouraged to talk to their doctors about what is best for their individual situation.

 

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