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Convert pain to tingling with electrical stimulation?


Instead of burning pain, just a tingling sensation - electrostimulation for pain therapy
Chronic pain can have different causes. One of these is the so-called neuropathy (nerve pain). Against this special form of chronic pain, doctors at the University Hospital Carl Gustav Carus Dresden use so-called spinal cord stimulation (SCS) - with success.

According to a message from the Dresden University Hospital, the SCS procedure is "only for selected patients with back and nerve pain", but they can be helped sustainably. For more than 20 years, the experts at the Clinic for Neurosurgery at Dresden University Hospital have been using SCS systems that use electrodes to stimulate certain nerve fibers along the spinal cord and thus suppress the transmission of pain messages to the brain.

Targeted stimulation of the spinal cord
If chronic pain due to neuropathies is difficult to treat, targeted stimulation of the spinal cord is a possible treatment option. However, the established therapy is not known to many, according to the university hospital. In addition, electrical stimulation close to the spinal cord remains tied to certain conditions and is only considered if no improvement can be achieved with other forms of therapy. If the initial conditions are met, electrodes can be implanted in the spinal cord as well as a small pulse generator as part of a small intervention. With their help, low-voltage electrical impulses can be delivered to the posterior strands of the spinal cord. The impulse transmission takes place epidural - over the hard meninges of the spinal cord. With a handheld device, patients can determine the strength of the stimulation themselves.

Tingling instead of pain
The transmitted electrical impulses stimulate certain nerve fibers along the spinal cord and they can no longer transmit their pain messages to the brain, the Dresden doctors explain. Abnormal sensations and pain that enter the brain via the nerve pathways are suppressed. "Thanks to the electrical impulses, the patient feels a more pleasant tingling sensation than a pain, like a massage - the so-called paraesthesia effect occurs," the message says. Many patients have already been helped with the procedure. The same applies to Sylvia Hesse, now 50, who reports on her experience with the treatment in the clinic's press release.

Long suffering of those affected
According to the clinic, the patient suffered a severe herniated disc more than 15 years ago and the pain had only been remedied by an appropriate operation for just under three years. Subsequently, severe pain returned, which the treating physicians could not “handle under further therapy or strong medication”, reports the university clinic. Changes in a vertebra would have further aggravated the patient's complaints. The source of pain was switched off in the course of a second operation, but afterwards the scar tissue continued to cause complaints for the patient.

Pain takes a back seat
"It was burning pain from the lower back to the toes," Sylvia Hesse is quoted in the current press release. Her life was only about the fear of even stronger pain attacks. She was no longer able to pursue her job as a geriatric nurse. Only six years ago did the patient learn about spinal cord stimulation and at the Dresden University Hospital the neurosurgeons found that the chances of success using this method were good. The decision for an operation was made and now the pain is there, but it takes a back seat, the woman reports of the effect.

Procedures with few restrictions
Thanks to the SCS procedure, the 50-year-old says that she hardly needs any medication today and can do her daily chores and everyday tasks as normal. Since the sensation of pain is often less in the morning than in the evening, the stimulator does not need to remain switched on all day. The electrodes in the back are noticeable, but the process brings hardly any restrictions. Only extreme sporting stress should be avoided and the patient should avoid the proximity to stronger electromagnetic fields such as induction cookers. In addition, the implanted pulse generator must be charged every eight days. After six years the battery was finally exhausted, which is why the Dresden neurosurgeons implanted a new device under local anesthesia at the beginning of April.

Two steps of implantation
According to the University Clinic in Dresden, the initial implantation of the SCS basically takes place in two steps. If the doctors have decided that a patient is suitable for the stimulation, the spinal cord stimulation is first tested on him. For this, the specialists only implant the electrodes, which is done under ongoing X-ray control to find the correct position. At the same time, a connected external stimulator is used to test whether the electrical stimulation reaches the patient's pain areas. For the optimal placement of the electrodes, the patients must be fully conscious, reports the Dresden University Hospital. However, the anesthetists involved ensure that the implantation is painless. "After a successful test, the battery-powered stimulation device is connected to the electrodes that have already been inserted," explains the university hospital, concluding the second step of the procedure. (fp)

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