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End of years of pain health beat 2022

traffic signal

Dorsal root ganglia are structures along the spinal column that are composed of densely populated sensory nerves.

Nerves act like traffic lights, “running and regulating interference for signals and sensations that travel through nerve fibers,” Dr. Chu said.

After an injury, the light turns green and indicates pain.

“That’s good,” said Dr. Chu. “We want to know when we have been injured.”

In most cases, treatment is started and the light turns back to yellow, then to red.

But this is not the case with some extreme trauma like Watson.

“It’s as if traffic signals are green all the time, allowing all pain signals to pass through even if there is no painful stimulus,” said Dr. Chu. “These cells continue to misbehave, even though the trauma is now gone.”

The pain then persists, becomes so intense that the skin becomes discolored, causing swelling under the skin and changes in temperature. It can also affect the growth of hair and nails.

“In these cases, people can be vulnerable,” he said. “Sometimes their limb or extremity becomes completely non-functional.”

The dorsal root ganglion stimulation device, approved by the FDA in 2016, is similar to a spinal cord stimulator. This disrupts the faulty signaling system, which sends low doses of electrical impulses directly to the dorsal root ganglia.

The device is somewhat like a “pacemaker for the spinal cord,” Dr. Chu said. “It causes the root ganglia to fire at appropriate physiological levels, rather than that hyper-stimulating pain state.”

finding relief

The first phase involves a trial run.

In this procedure, electrical leads are inserted along the spinal column using a needle, placing them near painful sites. In Watson’s case, this meant the lower lumbar spine.

But instead of surgically implanting the generator and battery, an external device is used. It is practically invisible under clothing and it operates without any external cables.

Patients control small generators using an app-based, wireless system connected to an Apple device.

That seven-day period gives patients a chance to see how their bodies react to neuromodulation. They can decide whether and how much it helps to improve function and reduce pain.

“I tell patients, ‘It’s my job to convince you to at least get tested, because I believe you’re a good candidate.’ But it’s their job to explain to me later if they want to go ahead with the transplant,” Dr. Chu said.

Treatment is not for everyone.

“It’s a risk-benefit analysis that each patient has to do on their own,” he said.

Watson experienced some discomfort with the trial period, which Dr. Chu said is not normal. But he also felt enough relief from the pain that he decided to go ahead with surgical implantation.

Dr. Chu inserted the lead and battery at the level of the waistband. Batteries usually need to be replaced every six years.

Just a few months after the surgery, Watson could resume some work at his small farm business in Wayland, Michigan. He can sit again, staying on the couch for a full church service, or watching an entire movie with his family.

The list of painkillers needed for him keeps on shrinking.

And he can’t stop feeling grateful for the enormous relief from this little device.

“Dr. Chu told me that if the procedure reduced my pain level by 50%, we would be able to reduce my pain medications and the procedure would be considered 100% successful,” Watson said.

So far, the results have exceeded those expectations.

“It reduced my pain by about 98%,” Watson said. “Most of the time, I’m almost 100% free of pain.”

After years of pain hovering around seven on a 10-point scale, his pain is now consistently between zero and one.

“I consider myself a poster child for this technology,” he said.

Watson said he felt relief almost immediately.

There are short-term limits when the incision heals, such as not lifting anything heavier than 5 pounds.

His family also saw a dramatic improvement.

“You can see how much better he is at the way he walks,” Jane said.

John is happy to be back to his old self. He is back to help more, taking care of his 96-year-old mother, who lives with him and his family.

They have an 18-year-old son, and they have a family dog.

Dr. Chu is thrilled to offer a modern solution to an age-old problem.

“Doctors have described this kind of complex regional pain syndrome as long ago as the Civil War,” he said.

“It’s too weak.”

Living with that level of chronic pain means that many people have to take pain medication, which can present problems.

“And this often leads to anxiety and depression, as people struggle with a lower quality of life,” he said. With the dorsal root ganglion stimulation device, “patients are finally getting significant long-term benefits.”

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