Neurostimulation for chronic pain

Electrode (green) with neurostimulator

Stopping continuous pain with electrical impulses
Neurostimulation is a treatment which alleviates chronic pain through electrical impulses. The method is suitable for patients who suffer from untreatable chronic pain following a back, knee, shoulder or hip operation or due to circulatory disorders (e.g. intermittent claudication or angina pectoris). Neurostimulation is also known as spinal cord stimulation (or SCS for short).

Electrodes intercept pain signals
Neurostimulation is applied to the spinal cord, which conveys pain signals to the brain. In order to interrupt this transmission, small electrodes are placed along the patient’s spinal cord. These electrodes emit weak electrical impulses that intercept the pain signals on their path from the spinal cord to the brain and replace them with formication (a tingling sensation under the skin), which the patient then feels in otherwise painful regions of the body. The electrical impulses are produced by a pacemaker that is about the size of the palm of the hand. It is implanted under the patient’s left costal arch (see the illustration on the left).

Treatment in two phases
First the electrodes are applied. This occurs during an outpatient operation, which lasts for one to two hours under local anaesthesia. This surgical intervention is accompanied by a test phase, allowing patients to verify how the procedure works and whether the neurostimulation helps. After a successful test phase, the pacemaker is permanently implanted below the left costal arch (the portion of the lower opening of the chest formed by the cartilages of the seventh to tenth ribs). This requires an hour-long operation under general anaesthesia.

Studies show excellent results
Neurostimulation has been used for 30 years; it is a safe procedure which has been successfully tested internationally. Most patients feel significantly less pain following neurostimulation, and some are even freed of pain completely. The PROCESS Multicenter study shows how well the method works for patients suffering from chronic back and leg pain following failed back surgery.

Process Study
Study: The effects of spinal cord stimulation in neuropathic
Study: Thoracic spinal cord stimulation
Press report in Ärzteblatt:
Fully implantable neurostimulation systems for spinal cord stimulation

Press report in BZ-Berlin:
"A pacemaker is beating in my back"

Effective indefinitely – reversible at any time
The life span of the electrodes is unlimited. The pacemaker has a lifecycle of four to six years and can then be replaced with a new device. The advantages of neurostimulation: there is no habituation effect to the electrical impulses – the effectiveness never decreases, and a higher "dose" is not necessary. Another advantage of the procedure is that it can be reversed at any time. If the patient no longer wants to use the implanted system, it can be either switched off or removed.

Treatment costs are covered by health insurance upon application
Both public and private health insurance companies cover the therapy costs if the physician submits an application that is medically justified.

Is neurostimulation a viable option for you? A quick check
Generally, patients are eligible for neurostimulation if they

have suffered from chronic pain for over three months
have not experienced sufficient pain relief through conventional treatments including medications or have felt unreasonable side effects
are not suitable for a (further) surgical intervention
do not exhibit contraindications, e.g. cancer or organ pain