Comprehensive Pain Management
(Formally known as Franklin Pain and Wellness and Warwick Pain)

Attleboro, MA(508) 236-8333
Franklin, MA(508) 507-8818
South Kingstown, RI (401) 234-9677
Warwick, RI(401) 352-0007

Franklin, MA • (508) 507-8818
Warwick, RI • (401) 352-0007
South Kingstown, RI • (401) 234-9677

Warwick Pain Center RI Blog

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Spinal Cord Stimulation

Joseph Coupal - Thursday, July 19, 2018
Comprehensive Pain Management in Warwick, RI

Chronic pain is long standing pain that persists beyond the usual recovery period or that accompanies a chronic health condition. Because this pain is not protective and is not a result of an ongoing injury, it is referred to as "pathological" and is therefore treated as a condition, not as a symptom. Chronic pain may prevent people from working, eating properly, participating in physical activity or enjoying life.

Spinal cord stimulation (SCS) is a pain-relief technique that delivers a low-voltage electrical current continuously to the spinal cord to block the sensation of pain. SCS is the most commonly used implantable neurostimulation technology for management of pain syndromes. As many as 50,000 neurostimulators are implanted worldwide every year. SCS is a widely accepted, FDA-approved medical treatment for chronic pain of the trunk and limbs (back, legs and arms).

There are three SCS device types:

Conventional systems require little effort on the patient’s part for maintenance. However, a minor surgical procedure is required to replace the power source when it runs out. Radiofrequency systems are designed to sustain therapy over long periods at the highest output level. Because of its high power capabilities, the RF system is suitable for the most challenging cases in which there is complex, multi-extremity pain. With this type of system, the patient must wear an external power source to activate stimulation. Rechargeable systems are the newest type of SCS device. The patient is responsible for recharging the power source when it runs low. A rechargeable system typically lasts longer than a conventional system. Eventually a minor surgical procedure may be required to replace the power source if the time between recharges becomes impractical.

SCS Trial Procedure

If it is determined that the patient is a suitable candidate for SCS, often the first step is to implant a device on a trial basis. During the SCS trial phase, a lead or leads are implanted temporarily and are connected to a trial spinal cord stimulator. The trial stimulator is programmed with one or more stimulation programs customized to the specific areas of the patient’s pain. The trial phase can be beneficial for the following reasons:

  • It can help the patient/physician analyze whether SCS effectively relieves pain
  • It provides the patient/physician with an assessment period to determine which type of SCS technology works best
  • It enables the patient/physician to evaluate different stimulation settings and programs

SCS Implantation

If the SCS trial provides adequate pain relief, then a permanent system may be implanted. SCS is a reversible therapy, so even though it is called permanent, treatment can be discontinued at any time and the implanted parts turned off and/or removed.

For more information on Spinal Cord Stimulation, contact Comprehensive Pain Management in Warwick, RI.

aans.org

Radiofrequency Ablation for Chronic Hip Pain

Joseph Coupal - Thursday, July 05, 2018
Comprehensive Pain Management - Attleboro, MA

Many people with osteoarthritis and other degenerative diseases, including posttraumatic pain and rheumatoid arthritis, suffer from chronic hip pain. Conservative treatment approaches such as physical therapy and analgesia may result in significant cost or adverse effects while providing only short-term improvement, and minimally invasive techniques have been found to be ineffective or of temporary benefit.

Although total hip arthroplasty (THA) is often performed in patients with advanced disease, the procedure is associated with a 5% to 15% failure rate, high cost, and increased morbidity, mortality, and persistent postoperative pain. In addition, the life expectancy of hip implants ranges from 10 to 25 years.

There has recently been renewed interest in radiofrequency (RF) procedures for joint pain resulting from degenerative conditions.

Clinical studies have shown that RF treatment is more effective than conservative methods in reducing hip pain. It works by interrupting the sensory input from the femoral and obturator nerves that innervate the hip joint.

The most common indication for RF was osteoarthritis, and other diagnoses included vascular necrosis and persistent pain after THA. Participants had moderate to severe hip pain and limited ambulation, and previously demonstrated a lack of response to oral analgesics and other conservative approaches.

Hip pain is a common condition that is often seen in elderly patients with multiple comorbidities. Often, pain medications are ineffective or have too many side effects, and injections only provide little or temporary pain relief. In addition, surgery may not be an option because of unwillingness of the patient or an especially high risk for complications related to comorbidities. RF treatment may be a reasonable alternative in these circumstances, as well as in situations involving long wait times for THA or persistent pain after THA.

For more information on RFA, contact Comprehensive Pain Management in Warwick, RI.

clinicalpainadvisor.com


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