By Becky Wiese
Patients who have undergone back surgery are typically well acquainted with pain. A long, drawn-out process begins with the injury itself, then perhaps includes a series of unsuccessful treatments to alleviate pain, and finally ends with the actual pain and recovery of invasive surgery.
By the time surgery is the best or only option left, pain has become a part of life, and not a welcome part.
The best outcome is for back surgery to fix the issue, whatever it was, and allow the patient to recover completely and be pain-free.
Sometimes the “pain-free” part only lasts for a matter of time, however. It’s not because the surgeon didn’t do it right.
“Failed Back Surgery Syndrome is a condition in which a patient has undergone successful back surgery — the surgery has fixed the problem — but the patient still experiences pain,” explains Dr. Ben Taimoorazy. “In these cases, the surgeon can’t do anything else because the problem is not caused by a surgically repairable issue. The cause of the pain in these cases is most likely a build-up of scar tissue in the spinal canal that is pressing against nerves, causing them to send pain signals to the brain.”
The solution to this type of pain involves a high-tech device and neurological trickery, not more surgery. “The surgery did what it was supposed to do, and more surgery would simply create more scar tissue,” says Dr. Taimoorazy.
Using the concept of neuromodulation and a device called a spinal cord stimulator, Dr. Taimoorazy can alleviate a patient’s pain. In simple terms, the strategy applies the gate theory of pain — a concept introduced more than 45 years ago that uses the open/closed gate idea about the transmission of sensation via the nerve. Basically, the theory says that if the nerve is stimulated with one type of sensation, it virtually closes the gate for other sensations to travel along the same nerve.
In the case of chronic pain, the plan is to use the spinal cord stimulator, which has two lead wires with electrodes, placed in the epidural space where the pain originates. The electrodes stimulate the spinal cord with low electrical activity, resulting in the patient feeling a tingling sensation or other pleasant feeling (like a massage) instead of pain. “In effect,” says Dr. Taimoorazy, “the brain is being tricked because the sensation caused by the electrical stimulation closes the gate to the feeling of pain. The cause of the pain [the scar tissue] is still there — the patient just doesn’t feel pain. The spinal cord stimulator replaces painful sensations with pleasant sensations.”
Pain can create a vicious cycle that leads to a chronic condition. Neurotransmitters conduct “conversations” between the neurons which can proliferate and cause new pain pathways to be created. For example, if you stub your toe, you feel pain radiate through your foot and perhaps even up through your lower leg, even though the actual point of contact is less than one square inch. This central sensitization of pain is what makes pain often feel “bigger” and more widespread, and often more intense, than it is.
With interventional options such as steroid injections, nerve cauterization, and spinal cord stimulation, however, back pain can be managed, and in many cases, eliminated.
This is the third of a three-part series. If you missed the previous articles, you may find them online at HealthyCellsBN.com
For more information, you may contact Dr. Benjamin Taimoorazy at Guardian Headache & Pain Management Institute, 309-808-1700, theGuardianPainInstitute.com. The practice is located at 2203 Eastland Drive, Suite #7, in Bloomington. Dr. Taimoorazy strives to increase awareness and understanding of different types of headaches and other chronic painful conditions and the available diagnostic and therapeutic options for each individual disorder.