If you suffer from neuropathic chronic pain, a new type of therapy called dorsal root ganglion stimulation, or DRG stimulation, could help you find minimally-invasive and highly-effective pain relief. It is most effective for patients with complex regional pain syndrome (CRPS).
For DRG stimulation, a pain specialist implants a small pulse generator under your skin, with four outward leads. These leads are then attached to the pulse generator and the painful area on your body. You then control the activation of small electrical impulses to these affected, painful areas. For patients with neuropathic pain, this can actually block the painful stimuli and provide very effective pain relief without medications. It also reduces the amount of paresthesias, or pins-and-needles feelings, that are associated with similar forms of pain relief.
Let’s talk some more about how this treatment works, the DRG stimulation procedure itself, and if it could work for you.
What is the dorsal root ganglion?
The dorsal root ganglion is a bundle of nerve cell bodies (i.e., a ganglion) located within the posterior region of various vertebrae along the spinal column. It is adjacent to the dorsal nerve root. The primary function of the dorsal root ganglion is to transmit information regarding your senses. As such, the dorsal root ganglion carries sensory neural signals from the peripheral nervous system to the central nervous system, which includes your spinal cord and brain.
Damage to or irritation of the dorsal root ganglion can lead to intractable symptoms of neuropathic pain that do not respond to typical treatments. This can lead to additional complications in the form of impaired functioning and pain. In these cases, more interventional approaches may be warranted, such as spinal cord stimulation or dorsal root ganglion stimulation.
Evidence has suggested that a new technique for neuromodulation is of the same dorsal root ganglion. The technique is nearly identical to spinal cord stimulation. And, it may also result in effective management of your chronic pain. Moreover, this DRG stimulation is considered to be an ideal alternative for some pain conditions, as it more effectively targets the specific pain location. It is especially useful for patients with complex regional pain syndrome (CRPS).
The first application of dorsal root ganglion stimulation was conducted in 1991 in a sample of rats. These studies found that dorsal root ganglion stimulation resulted in favorable effects on the inflammatory responses of these rats. Since this study, a number of trials of DRG stimulation have been conducted. As the Cleveland Clinic reports, the FDA approved DRG stimulation in February 2016 for the treatment of certain pain conditions in humans.
How Is Dorsal Root Ganglion Stimulation Performed?
As noted above, dorsal root ganglion stimulation is almost identical to the traditional spinal cord stimulation procedure; however, the dorsal root ganglion is targeted, rather than the spinal cord. Thus, dorsal root ganglion stimulation involves implanting electrodes, which are uniquely designed for use on this type of nerve bundle.
Along with the electrodes, a stimulation device is also implanted. This sends electrical impulses to the specified area of the dorsal root ganglion. This interrupts the transmission of pain signals from the peripheral nervous system, through the dorsal root ganglion, to the spinal cord and brain. And this prevents you from feeling as much pain.
Moreover, stimulating the nerve bundles with low intensity electrical impulses can replace the sensation with a pleasant tingling sensation, known as paresthesia. The device itself generates electrical impulses from a battery. You can program it using an external handheld device. These batteries need to be changed approximately every two to five years.
Watch a Texas doctor talk about the procedure below, along with the patient who found immense pain relief from it. This procedure was also made possible by a partnership with St. Jude Medical.
What Are DRG Stimulation Benefits?
By applying stimulation to the specific region of the dorsal root ganglion that is responsible for the pain, the benefits can be huge for patients. With DRG stimulation, there is:
An opportunity to treat pain that hasn’t responded to other treatments
Less need for medications
Decreased parasthesia, or pins-and-needles, feelings
Much more effective and targeted pain relief
Less stimulation of the neural network in general
Another benefit of DRG stimulation is related to the fact that the dorsal root ganglion lacks the protective membrane that is found on other peripheral nerve fascicles. Instead, the dorsal root ganglion is surrounded by a permeable connective tissue coating. This makes it an ideal target for the application of neuromodulation.
“At 12 months, patients who responded to the therapy were reported to have both less discomfort, and also improved mood scores. The pain-relieving stimulation can be flexibly programmed so that if a patient prefers, the therapy can create a tingling sensation of paresthesia. In many patients relief occurs without parasthesia.”
Conditions Related to Dorsal Root Ganglion Stimulation
Damage to the dorsal root ganglion can occur either by direct injury to the nerve bundle itself or by compression from local inflammation or infection. Irritation or damage to the dorsal root ganglion can result in symptoms of chronic pain. DRG stimulation is most often used for: