What is Spinal Cord Stimulation?

Spinal Cord Stimulation

Spinal cord stimulation patients use an implanted device to send electrical signals to the spinal cord in order to provide pain relief. The stimulator is activated by the patient using a remote control that triggers the implanted device to send electrical signals to the spine. The internal stimulator consists of electrodes placed near the spinal cord and a small battery pack that is often placed in the abdomen or the buttock. 

This treatment method is often used when nonsurgical treatment options have proven ineffective at reducing pain.  

Treatable Conditions

Spinal cord stimulation is used to treat several conditions that lead to chronic pain, including post-surgical pain, inflammation, peripheral vascular disease, neuropathy, post-amputation pain, and other types of pain causing conditions. When other surgical options to treat back pain are not successful, back pain can be treated by spinal cord stimulation. Arachnoiditis, pain caused by inflammation of the membrane that covers the brain and spinal cord can also be treated using this procedure. Likewise, patients suffering from certain types of abdominal pain such as visceral and perineal pain may also benefit from spinal cord stimulation. 

During the Procedure

Implantation of the device usually is performed in two phases, the first of which is a trail period. During the trial period a temporary device is implanted using a type of x-ray technology, known as fluoroscopy, as a guide to assist in the proper placement of the electrodes into the spine. During the trail phase the battery pack remains on the outside of the body and is usually worn on a belt around the waist. Then, pain levels are tracked for a period of time after implantation. If the patients’ pain is significantly reduced by the device, a permanent option may be considered. However, if a satisfactory level of relief is not reached with the temporary device, it can be removed without injury to the spinal cord and nerves.

For those who move on to the second phase, which involves implanting a permanent device, another surgery is required but this is usually performed as an outpatient surgery. During the procedure the previous electrodes are replaced and secured more permanently in the affected area to prevent shifting. The battery pack is also implanted beneath the skin at this time. All together the procedure takes a couple hours, during which the patient may remain awake to help the surgeon to ensure proper placement of the electrodes into the spine to provide the most relief.

Expected Outcome

Usually patients are released the day of the procedure with certain restrictions. Patients may be asked not to perform certain movements that are likely to pull at the incision sites, such as stretching and twisting, for a period of time following the procedure.  Most patients return to work, with their surgeon’s approval, within a couple of weeks following the procedure.

Side Effects and Complication

 As with any surgery, some complications are possible these include bleeding and infection at the site of the incision. Another possible complication includes, instances where the electrodes shift from the intended location, reducing the level of pain relief. In these instances, additional surgery may be required to return the electrodes to their original location. If the stimulator breaks, due to a fall a new device may need to be re-implanted. In some instances, the dura mater that surrounds the spinal cord may be punctured by a needle or electrode during the surgery resulting in leaking spinal fluid. Consequently, severe headaches may occur. Also, trauma to the spinal cord that may result in paralysis may occur during surgery; although, this complication is rare. 

Driving and operating heavy machinery are not recommended when using a spinal cord stimulator. The device should be switched off before performing these activities.

 

https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/treating-pain-with-spinal-cord-stimulators

https://www.webmd.com/back-pain/guide/spinal-cord-stimulation

 

How Yoga Helps Reduce Back Pain

Physical Benefits of Yoga Exercises

Strengthening from holding yoga positions. Yoga helps increase strength in very specific muscles and muscle groups. Holding positions in yoga is not intended to be uncomfortable. However, it does require concentration and specific use of muscles throughout the body. Muscle strength improves by remaining in these yoga positions and incorporating various movements.

Many of the postures in yoga gently strengthen the muscles in the back, as well as the abdominal muscles. Back and abdominal muscles are essential components of the muscular network of the spine, helping the body maintain proper upright posture and movement. When these muscles are well conditioned, back pain can be greatly reduced or avoided.

Stretching and relaxation from yoga. Yoga incorporates stretching and relaxation, which reduces tension in stress-carrying muscles. Yoga requires that the individual hold gentle poses anywhere from 10 to 60 seconds. Within the pose, certain muscles flex, while others stretch, promoting relaxation and flexibility in muscles and joints.

For people with lower back pain, stretching is very important. For example, stretching the hamstring muscles (in the back of the thigh) helps expand the motion in the pelvis, decreasing stress across the lower back. In addition, stretching with yoga increases blood flow, allowing nutrients to flow in, toxins to flow out, and overall nourishment of the muscles and soft tissues in the lower back.

Breathing is considered very important during the yoga poses. While holding a position, the tendency is to hold the breath as well. Instead, the intention is to have a deep, free, and rhythmic breath through the nose on both the inhale and the exhale. The quality of the breath in many ways determines the quality of the yoga practice. This will emphasize a relaxed body and encourage strong circulation.

Posture, balance, and body alignment through yoga. The yoga poses are meant to train the body to be healthy and supple. Consistent practice and application will result in improved posture, and an increased sense of balance, with head, shoulders and pelvis in proper alignment. Additionally, unlike many other forms of exercise, yoga helps stretch and strengthens both sides of the body equally.

Awareness of the body through yoga increases with practice. In theory, specific positioning and repositioning not only limbers the body, but also trains people to understand the limitations of their body. An increased awareness acts as a preventative measure, in that the individual will know what types of motions should and should not be avoided.

Mental Benefits of Yoga Exercises

Engaging in Hatha yoga affords the practitioner with a mental state of mind that is ready for meditation, which in turn reduces stress and enhances mood. These mental benefits play an important role in the overall healing benefits of yoga.

There are several theories as to why a mental state of mind may affect those suffering from back pain.

  • Many believe that suffering from back pain increases because of perception. Negative psychological and emotional factors may not necessarily change the physiology of the back, but may tend to magnify a problem that already exists. Thus, reducing the perception of the pain (such as through meditation) can reduce the overall feeling of back pain.
  • Others take the role of mental factors one step further. They believe that psychological and emotional factors are the primary influence in the sensation of pain and can physically alter the body. For various reasons, high stress and negative emotions may actually cause back pain. This will in turn create negative psychological and emotional feelings, perpetuating the cycle.

In theory, yoga helps people concentrate their energy on breathing and maintaining posture. The methodical breathing increases oxygen flow to the brain and sets a rhythm within the body and mind. This action coupled with the poses and sometimes meditation is said to dissipate stress and anxiety, therefore, relieving back pain caused by psychological and emotional factors.