The end of years of pain | health rhythm

John Watson’s troubles began in the summer of 2014, when a rare and rapidly evolving skin infection nearly killed him.

He underwent multiple surgeries.

With each one, doctors warned her she would likely be dealing with ongoing chronic pain.

Those warnings did not alarm Watson, 63, or his wife, Jen, during that harrowing period.

“It was such a traumatic and scary time,” Jen said. “So when we hear them say, ‘John, you’re going to be in a lot of pain, but you’re going to live,’ we don’t give much thought to what they mean by pain.

“We were so happy that it was able to pull through.”

As the months of recovery passed, including skin graft surgeries, she faced the daunting transition to chronic pain.

The intensity was relentless, radiating from the lower back, down the left leg and up the abdomen.

Medications offered some help. He sometimes received nerve block injections, which provided wonderful but short-lived relief.

Then, in 2021, he met with Yi Jia Chu, MD, who specializes in interventional spine and chronic pain management at Spectrum Health Spine & Pain Management Center.

Dr. Chu has had great success implanting a dorsal root ganglion stimulation device in patients struggling with chronic pain.

The device is not for everyone, said Dr. Chu.

But it can be life-changing for patients like Watson, who lives with a type of pain known as complex regional pain syndrome. It is estimated that 200,000 people are affected by this syndrome each year in the US.

Traffic signals

Dorsal root ganglia are structures along the spinal column that are made up of densely packed sensory nerves.

Nerves act like traffic lights, “interfering with and regulating the signals and sensations that travel through nerve fibers,” said Dr. Chu.

After an injury, the light turns green and lets pain signals through.

“That’s good,” said Dr. Chu. “We want to know when we are injured.”

In most cases, healing begins and the light turns yellow and then red again.

But in the case of some extreme trauma, like Watson’s, that doesn’t happen.

“It’s as if the traffic lights stay green all the time, allowing all pain signals to get through, even when a painful stimulus is no longer being produced,” said Dr. Chu. “These cells misbehave, even though the trauma is gone.”

The pain then persists and becomes so intense that it causes the skin to discolor, creating swelling and changes in temperature under the skin. It can even affect the growth of hair and nails.

“In these cases, people can be weakened,” he said. “Sometimes your limb or limb stops working altogether.”

The dorsal root ganglion stimulation device, approved by the FDA in 2016, is similar to a spinal cord stimulator. It interrupts that faulty signaling system, sending low doses of electrical impulses directly to the dorsal root ganglia.

The device is a bit like “a pacemaker for the spinal cord,” said Dr. Chu. “It causes the root ganglia to fire at appropriate physiological levels, rather than in that hyperexcitable pain state.”

find relief

The first step involves a test run.

In this procedure, electrical wires are inserted through the spine with a needle, placing them near the painful places. In Watson’s case, that meant the lower lumbar spine.

But instead of surgically implanting the generator and battery, an external device is used. It’s virtually invisible under clothing and works without external wires.

Patients control the tiny generator using a wireless app-based system connected to an Apple device.

That seven-day period gives patients a chance to see how their body reacts to the neuromodulation. They can decide if and how much it helps improve function and reduce pain.

“I tell patients, ‘It’s my job to convince you to at least get tested, because I think you’re a good candidate.’ But it’s their job to convince me afterwards if they want to go ahead with the implant,” said Dr. Chu.

The treatment is not for everyone.

“It’s a risk-benefit analysis that each patient has to do on their own,” he said.

Watson experienced some discomfort with the trial period, which Dr. Chu says is not typical. But he also felt enough pain relief that he decided to go ahead with the surgical implantation.

Dr. Chu inserted the cables and battery at about waist level. Batteries typically need to be changed every six years or so.

Just a few months after the surgery, Watson was able to resume work at his small farming business in Wayland, Michigan. He can sit still again, stay in a pew for a full church service, or on the couch to watch a full movie with his family.

The list of pain relievers you need keeps shrinking.

And you can’t help but feel grateful for the great relief of this little device.

“Dr. Chu told me that if the procedure reduced my pain levels by 50%, we could reduce my pain medications and the procedure would be considered 100% successful,” Watson said.

So far, the results have exceeded those expectations.

“It has reduced my pain by about 98%,” Watson said. “Most of the time, I am almost 100% pain free.”

After years of pain that hovered around seven on a scale of 10, her pain is now consistently between zero and one.

“I consider myself an example of this technology,” he said.

Watson said he felt relief almost immediately.

There are short-term limitations while the incisions heal, such as not lifting anything heavier than 5 pounds.

His family also noticed dramatic improvements.

“You can see how much better it is just from the way it moves,” Jen said.

John is delighted to be himself again. She has returned to help more, taking care of his 96-year-old mother, who lives with him and his family.

He has an 18-year-old son and a family dog.

Dr. Chu is delighted to offer a modern solution to an old problem.

“Doctors have described this type of complex regional pain syndrome since the Civil War,” he said.

“It’s so debilitating.”

Living with that level of chronic pain means that many have to take pain medication, which can present problems.

“And it often leads to anxiety and depression as people struggle with a diminished quality of life,” he said. With the dorsal root ganglion stimulation device, “patients ultimately see significant long-term benefit.”

Leave a Comment