STUDY: Spinal Cord Stimulation Reduces Emotional Aspect of Chronic Pain

STUDY: Spinal Cord Stimulation Reduces Emotional Aspect of Chronic Pain

Talk to a chronic pain sufferer and he or she will tell you of the negative residual effect that pain has on their emotions and their mood.  That’s why we found this research news from Columbus, Ohio

Researchers at The Ohio State University Wexner Medical Center report that patients who have chronic pain can reduce their emotional response to pain through spinal cord stimulation.

The study results are published in the latest issue of the journal Neuromodulation: Technology at the Neural Interface.

“Our initial study provides insights into the role of the brain’s emotional networks in relieving chronic pain.  We are the first to show that therapeutic spinal cord stimulation can reduce the emotional connectivity and processing in certain areas of the brain in those with chronic pain,” said principal investigator Dr. Ali Rezai, director of the Center for Neuromodulation.

“Being able to modulate the connections between the brain areas involved in emotions and those linked to sensations may be an important mechanism involved in pain relief linked to spinal cord stimulation.”

Researchers studied 10 patients who were living with severe chronic leg pain who were implanted with a spinal cord stimulator to reduce their pain.  This research builds off previous findings that proposed the concept of the neuromatrix theory of pain, in which pain perception varies according to cognitive, emotional and sensory influences.

The default mode network (DMN) is the resting state network of the brain and plays a key role in the cognitive and emotional aspects of pain perception.  It’s also associated with functional connectivity hubs and brain networks.  The resting DMN is abnormal in patients with chronic painful conditions, implicating the impact of such chronic conditions on areas beyond pain perception.

“By using functional magnetic resonance imaging (fMRI), we mapped the areas of the brain involved in pain perception and modulation.  If we can understand neural networks implicated in the pathophysiology of pain, then we can develop new therapies to manage chronic persistent pain,” said first author Dr. Milind Deogaonkar, an Ohio State neurosurgeon who specializes in neuromodulation.

Subscribe to our blog via email

Enter your email address to subscribe to this blog and receive notifications of new posts by email.

Authored by: Staff

There are 23 comments for this article
  1. Tim Mason at 12:57 pm

    You will find only positive results from the studies done by the manufacturer. Medtronic. Look up NIH studies and some done abroad for “the rest of the story” as Paul Harvey used to say.
    One aspect of low back pain and previous surgeries is the possibility of developing leg weakness and tingling 1 to 5 years post fusion. That is where I am. My pain is taken care of with morphine and oxyconten but weakness will need additional surgery if I can get them to do it.

  2. Bob Schubring at 11:15 pm

    What should concern us immensely, is Texas’ experience with these surgical procedures on the spine.

    Former Texas Governor Rick Perry, better known for leaving office while under indictment for felonious abuse of power, rammed through what he called a “tort reform” statute, that prohibited nearly all medical malpractice claims.

    This opened the floodgates for shrewd businessmen with medical degrees, to perform unnecessary and harmful spinal surgery to implant devices in the spine. The businessmen argued that they were working to diminish opioid dependence, and therefore, the injuries they caused and the money they squandered, was for the public good. Patients who suffered actual harm from the Perry policy, had no legal standing in the state courts to sue on any legal theory that constituted malpractice of medicine, because the Perry law prohibited most such suits.

    What has not yet been attempted in Texas, is to sue the state under the Americans With Disabilities Act, and actually command it to provide patients the reasonable accommodation of disability, of giving them whatever sort of pain treatment works safely with the fewest complications, in their own personal cases. If Cat were a Texan, she’d be in grave danger of having her spine carved up and botched, if she happened to reside in the same county as one or more of these shrewd businessmen’s spine surgery clinics. The “standard of care” within that county, will be that opioids are only prescribed for chronic pain, after spine surgery has been botched and has created new pain, far beyond the pain that patient originally had.

  3. Cat at 5:26 pm

    I have been a chronic pain patient for a very long time due to SLE, FM, RA, a frozen sacroiliac joint and bulging/herniated disks in my cervical and lumbar spine. I have tried some things which offered temporary relief: acupressure, massage, reflexology, Bowen Therapy and chiropractic. My pain is not the same each day. I now take three 10mg oxycodone per day for my pain. Some days it is enough. Most days it is not. I am concerned over the sudden insistence that pain patients have things injected or implanted into their spines for pain. It is like the Emporer’s New Clothes; we know they are not the ideal solution and we also know that the statistics supporting the opioid “epidemic” are being manipulated. I’m not willing to risk permanently injuring my back by letting someone stick something in my spine when three pills a day will satisfy me. I am a 60-year-old woman who owns a home and a business. I have worked since I was 14-years-old. I am not a drug addict. I am a chronic pain patient who cannot understand why I suddenly feel I have been placed in an adversarial position with my doctor. My pain management doctor told me a spinal injection is as curative as surgery. I don’t believe it.

  4. Jean Price at 8:33 pm

    I believe technique does have a lot to do with success in this area of pain management. Also, a doctor should do a temporary trial and if the pain is not relieved by 50% or more, it really isn’t a viable option, and they won’t go ahead with permanent placement. This is information I received from a pain management Doctor prior to moving out of his state. I would have no reason to doubt his information, and it sounded very plausible to me. He said it was also good to call the company and see who did the most in your area, and have your family doctor contact the services reps and see who had the best results! (I don’t have one, myself…due to a poor track record in adverse outcomes for invasive procedures!). I offer this as FYI to anyone considering pursuing this.)

  5. Lynda L. at 8:00 pm

    Julie if you want to contact me privately, I bought the book and it’s fantastic. I think all pain patients need to get this book. I’ve brought my books to my local libraries for donation to put on the shelves so others can borrow it. Many libraries will put more informative books on their shelves as long as we give them all the information that the require.

    I have RSDSA and RSDHope support group and I’m advocate for US Pain Foundation. I have an extra copy I’d like to send to you. I’m not some weirdo. Feel free to call me 440-476-1359

  6. Donna at 7:44 am

    My Spinal Cord Stimulator is the biggest joke ever, Number one it’s for Dr’s and Hospital to make more money… it’s a failure, Im living in hell!

  7. Carla Cheshire at 8:31 pm

    Bob, You are able to adjust the intensity of the electronic pulse with today’s stimulators. You can up the sensation or lower it, faster or slower, harder and softer.

  8. Doug at 5:14 pm

    I have both cervical and lumbar implants. I wish I would have never gotten them. My experience has been nothing short of a failure and I am now suffering more pain then I did before getting the implants.
    Up until getting them I was able to work a 40 hour a week job. Afterwards, I am unable to stand on my feet for more than 30 minutes at a time. I am unable to walk more then a city block without having to rest, and I am unable to work period.
    Although I personally wouldn’t recommend getting a stimulator to anyone, I do know that there have been some positive results too. I believe that way more than 10 people should be studied because how do we not know that this wasn’t a stacked deck of cards just to sell a product?
    My suggestion to anyone who is thinking about this procedure would be to research reviews on the Internet. You may be surprised at how many dissatisfied people that there really are.

  9. Julie at 4:35 pm

    Tim,

    Thank you for the information on the book. I may have to get it at some point i.e. when I can afford it. ( My husband has been out of work for three weeks.) The book does sound interesting and would be great to read if for no other reason then I’m always looking for different approaches to pain.

    Unfortunately, I know all too well about spinal cord stimulators. Like Lynda, I have RSD. The surgery to implant the SCS actually caused a spread of my RSD. While the trial was a success, the implantation was a disaster for that reason. However, I know many others who have gotten great results from the scs. That’s one of the reasons why I think this study group was too small. You can’t get a good sampling when a group is this small. Plus if the scs works great for them, the reduction in pain could be the cause of the improvement in mood and emotions rather than it being from the scs per se.

  10. Cynthia at 4:18 pm

    I could be wrong, but I think the new digital SCSs, which are the size of a fingertip, are wireless and do have a remote that you use….will look it up soon. One is made by STIMWAVE and was just recently approved in US. They have been In Europe for a while already. There’s another new type, also, called HF10 therapy, high frequency, no buzzing. Sorry I don’t have more exact detail….I saw these in PAIN PATHWAYS magazine.

  11. Deb D at 11:43 am

    All things come with risk. My husband had a two level fusion in 2001. Followed by no pain relief, multiple spinal injections, opiates, finally, a trial and implantation of a nerve stimulator. Worked fine for a few months, then lead/paddle problems. When he had additional surgery to replace leads and battery, ended up with MRSA, vancomyacin and 30 days inpatient. No more nerve stimulator for him. Research and do your homework. Might be an option for some, but I would take the docs and reps for the stimulators comments about efficiency and pain relief with a big grain of salt.

  12. Claire Saul at 7:57 am

    I also agree that the study is too small to be of real significance. I had a scs implanted 7 months ago at St Thomas’ hospital, London after many years of failed surgeries for chronic nerve damage. At St Ts’ we had to be part of a programme for the neuromodulation process: initially assessed by a consultant, a specialist physio and a clinical psycholgist; then if accepted we were inpatients on the pain unit for a 2 week course. My course was last May and I was one of 11. We were given different pain management techniques, taught about the physiology and psychology of chronic pain and perhaps most importantly prepared realistically for the possible outcomes of scs. The expectation was that 8 or 9 would choose to go ahead with the trial, and that out of these the trial would be successful for approx 70% leading to full implant. We were told that if we were unable to determine a difference during the trial, taking on board the different type of pain the surgery would give and distinguishing it from our pain, then the scs would not help. It is like someone taking a first hit of heroin – it will never be as good again! I was still on opiates and lyrica when I had the trial and remain on meds now. This is definitely correct and those of us who had the full implant after a 2 week trial all report that the stimulation is not as strong as it was initially. For me it has helped – it certainly hasn’t got rid of the pain and when it is switched off I have no relief, but it has given me an element of control back. If you are interested I started a blog when I had the trial http://www.painpalsblog.wordpress.com

  13. cynthia at 10:00 pm

    i’ve been thinking about trying one of the new tiny digital SCS’s. but when i read stories like these, i realize is really am terrified of anything invasive. i’ve had bad pain for 8 years, several docs want to do fusion. no way. not interested. won’t even do an epidural. i know too many people who’ve have horrible experiences with them. so i just live in pain….and that’s that. thank you for your stories…

  14. Tim Mason at 7:55 pm

    Julie, the spinal stimulators are discussed in detail in the book I mentioned in this thread. This book is only $15 plus shipping. Chapter 20 covers -Spinal Cord Stimulators, Spinal Drug Delivery (pumps), Peripheral Nerve/Field Stimulation. There are about 18 pages of detailed color plates in the back. The book will fit in your purse. I guarantee you will love this book. I am going to write the authors and personally thank them for such a concise and informative work. the Look up the reviews ISBN 978-1-57826-408-7
    There are other studies done by NIH and some in other countries that detail the failures you need to see concerning SCS.

  15. Bob Schubring at 6:47 pm

    I’m curious what would happen, if the patient had a control knob somewhere (maybe remote control using a Bluetooth cell phone?) that could change the stimulation. If that was possible for breakthrough pain, the stimulator companies would sell a lot more of them. Who wouldn’t want a breakthrough pain reliever, that worked in 10 seconds or less?

  16. Lynda Louisa Avallone at 10:59 am

    Hi. I was injured in June 2011. I tripped over a whiteboard marker and eraser that a coworker dropped behind my desk. I didn’t see it and I went to put the mail in the mail slots and I twisted my whole right leg. Especially my right foot and ankle. By mid July the WC doc diagnosed me with RSD and instructed me on what it is etc. I was blessed that he caught it and sent me to a fantastic PM doc. By November 2011 I spread full body to include my brain and digestive system. My PM had me do a trial SCS. OMG it worked so good. So we got approval from my insurance. WC to this day will not pay for my PM. They won’t even allow me water therapy or a walker. So my insurance approved it and I don’t know what happened. The trial went in so easy but it to Medtronic Rep and my doc 4 hours to get that thing in there. It worked great for 6 months. Then all of a sudden my leads were not working. We did an X-Ray and I didn’t do anything to move the leads. They were straight. So I had to go to neurosurgeon to implant the paddle in my spinal column. My nerves built collateral nerves so it rerouted them off the leads. Both docs said that is extremely rare. When he got in there he ended up taking almost four hours when at most it should have been two. I had two laminectomies and he had to wait while they had to find the machine to cut through calcified cartilage in between the vertebrae and spinal cord. He couldn’t get it straight and he went higher. It was left of center. It worked for other patients but for me it pulled on my stomach and any attempt to adjust that thing caused me to puke or heave. So six months of that my PM sent me back to neuro and he went back in. Two more laminectomies and he got that paddle straight. When I got home and the medication and anesthesia wore off I had excruciating pain and spasms like a big truck tire all around my abdomen. It took that man a week to get me back into surgery. Mind you he didn’t give me post surgery meds for breakthrough pain. I could only cry for a whole week. My husband called that office multiple times. When he went in there to remove it the end of the paddle was crimped digging into my spinal cord. From that day, I think 2yrs I can only eat jello and yogurt and other soft foods. I haven’t been able to sleep in my bed with my husband since the first time the neurosurgeon operated on me. I’ve been stuck in a recliner.
    I share my story not to scare you or turn you away from getting one. Because they can be very helpful and relieve pain. I just have a disorder with my nerves making RSD that much more difficult for my PM to treat.

  17. Bonnie at 10:22 am

    I had 2 different kind of spine stimulators put in and they were both a disaster. After 4 surgeries, I still have a paddle of wires laying on my spinal cord which keeps them from doing MRIs to track my MS and any kind of electrical stimulation sends my body into spasms.
    My back is in pain all the time and the Neuro surgeon refuses to operate on me again. So be careful, especially using something they say is new. I went through this back in 2012. And now I can not stand up for more than a couple of minutes.

  18. Carla Cheshire at 10:09 am

    After failed back surgery and couple years of constant radiating nerve pain I had a spinal cord stimulator implanted. My doctor recommended an over a weekend trial, in which I was still taking opioids for pain. It was very hard for me to tell whether it was effective during the trial. The doctor was pushing me to try it so I had the implant done. It seemed to dull the pain signals somewhat but it was not really helpful enough in my case. I was unable to discontinue opioid therapy and I had the stimulator removed after 6 months or so.

    A couple things: Check to see how often the batteries need to be changed out. At the time I had the stim they had to do surgery to change the battery. The stim was implanted in my hip area. I bumped the stim site inadvertently a couple times and it caused extreme pain. It is safer if the implant is in an area where it will not be disturbed often. It is not comfortable. Also, I believe prescribing doctors get some sort of monetary compensation from the manufacturers of the stimulators when a patient gets an implant. They didn’t mention if the people in the study cited in this article are connected to the manufacturers or not. I agree with the above comment that the study size is too small to be of much consequence.

  19. Tim Mason at 6:41 am

    After purchasing and reading a book promoted by the National Pain blogger, “Pain-Wise” – “A Patients’s guide to Pain Management” by David Kloth, M.D. and Andrea Trescot, M.D. and Francis Riegler, M.D. , there are many other procedures that can be done to help alleviate pain. One of these is ACUTHERM decompression catheter by NeuroTherm.
    This book should be the “Bible” of any chronic pain patient. This book is worth 10 times what I paid for it. I urge everyone to purchase a copy of this book today. This book also answered a lot of questions for me that I had concerning the complaints from so many not getting their prescription medications.

  20. Robin Berryman at 6:29 am

    I have two Spinal Cord Stimulator for CRPS/RSD, first one placed in 2013, second in 2014 (accident was in 2/2011.
    I am currently engaged in physical therapy and being taught about the Physiology
    connection to my pain. This is just started for me and I have this week changed my diet to help reduce inflammation in my body and reduce my pain.
    In your trial what were your findings about how soon after initial injury did implanting the Stimulator become become more effective? I am so interested in this study . Robin
    Berryman r.rberryman@yahoo.com

  21. Julie at 6:04 am

    This just seems to be an awfully small research group to draw many conclusions. For many, the spinal cord stimulator works very well helping with their pain. Anytime your pain is decreased, your emotions and moods do get better. I think it’s more that the pain was controlled rather than the spinal cord stimulator was the cause of the shift in the emotions and mood. It would be nice to know if all of these patients had a success with their spinal cord stimulator or if any of them had a failure.