A neurostimulator is a device which is implanted near the spinal cord or a peripheral nerve. The device uses small electrical impulses to interrupt pain signals sent to the brain. In people with chronic pain who use neurostimulation as a treatment, instead of feeling pain, they will experience a tingling sensation. Neurostimulation is generally only recommended as a treatment option when other measures for pain management have failed.
The idea behind neurostimulation is relatively straightforward. In people with chronic pain such as that caused by peripheral neuropathy, sciatica, or complex regional pain syndrome, the pain can become persistent and unrelenting. The nervous system has gone awry, sending pain signals when no actual pain is being experienced, and the pain can be extremely intense. Instead of being a useful signal that something is wrong, the pain is simply an unwanted intrusion.
A variety of pain management options are available for these patients. If these methods are not effective or if they lose effectiveness, implantation of a neurostimulator may be considered. Before surgery to implant the device, the patient usually has a trial period, in which leads are placed and the patient is given low levels of electrical stimulation for several days. This allows the patient to see if a neurostimulator would actually help, and to perfect the placing of the leads so that the device will do the most good.
If the trial goes well, during a surgical procedure the pacemaker-sized neurostimulator will be implanted by a surgeon. Some devices are entirely internal, which means that surgery will be needed again in the future to replace the power supply. In other cases, a receiver is implanted under the skin, and the patient wears a battery pack and antenna. Surgeons can discuss the risks and benefits of each type.
Also known as an implanted pulse generator, a neurostimulator can make a significant difference in quality of life. It may enable the patient to engage in more activities, and to be more active and involved in the lives of others. The device is usually adjustable and programmable, and can be periodically evaluated by a neurologist, a nurse, or a technologist to confirm that it is working properly and to make any necessary adjustments. Remote reading of the battery capacity in internal devices can also be conducted periodically so that the device can be replaced before the batteries run all the way down, ensuring that the patient will not have to be in pain because of a dead battery.
