Why is it when you aren’t feeling well, having someone rub your back makes you feel a little bit better? Or, when your knees ache, you automatically rub them? It may be that this instinct actually helps dull the pain in part by activating other senses—such as touch and vibration.
For our brains to detect sensations, we have receptors throughout the body that, when activated, transmit signals up the nervous system. The ones that detect touch and vibration are known as mechanoreceptors. Other ones include thermoreceptors, chemoreceptors, and photoreceptors. But the notorious one is the nocireceptor because it is the one that senses pain.
Using electricity as medicine
Some receptors, like the mechanorecptors in the skin, require less stimulation to be activated than other receptors. Activating these lower threshold receptors may interfere with the activation the higher threshold nocireceptors. This idea is famously known as the “gate control theory of pain.” And though not a complete
picture of the neurophysiology of pain, doctors used this idea in the 1960s to treat patients with chronic pain. They designed a device that had a small electrical generator connected to an electrode, and implanted the electrode near major nerve centers.
Like a pacemaker for the spinal cord
The device transmitted varying frequencies of electrical impulses. It functioned like a pacemaker in the heart, but for the nervous system. When it was implanted near the spinal cord, known both as both a dorsal column stimulator and spinal cord stimulators (SCS), it appeared to interfere with the sensation of pain. Neurosurgeons and interventional pain specialists now use them consistently to treat chronic pain. Patients can use an external controller to modulate electrical impulses.
SCS is indicated for many chronic pain syndromes
SCS is supported in the treatment of multiple disorders, but the best—at least 50% improvement in pain symptoms for the first year post procedure—seems to be for neuropathic limb pain. It is also indicated in aiding in the management of chronic pain associated with the following:
Usually, SCS is a near-last line of treatment for chronic pain. Only you and your physician can determine if you are a candidate. You may call us at 888.724.6377 to learn more or to find out if you may be a candidate.
Everyone is affected by the opioid crisis. For many of us, the crisis has been personal. Illicit drugs, prescription drugs and mental health have all played their part. Some argue that the crisis started with an effort to treat pain, codified in hospital protocols.[i] Others said that drug companies played down the addictive effects of opioid prescriptions and incentivized prescribing them.[ii] In response, the medical community has tried to help. There is now renewed focus on mental health and substance abuse treatment.[iii] Unfortunately, there has been a history of naiveté amongst many physicians, especially two decades ago when prescribing opioid long term for chronic pain was much more common. However, at least one physicians group sounded the alarm very early on, and dedicates much of its time towards advocating for opioid prescription accountability.
Angelie Singh, MD, MPH, MS