Implantable Devices for Back Pain Relief

Some patients may continue to require care for the treatment of their back pain symptoms even after conservative and invasive treatments have been used. Implantable devices for back pain relief include those that deliver stimulation to the areas around the spinal nerves, and those that deliver narcotic medications. Let's take a look at what implantable devices are available, how they work, and what types of benefits they offer that other back pain treatments don't.

Neurostimulators and Drug Pumps: The implantable devices that are used to treat chronic back pain are either neurostimulators or drug pumps. These devices involve the long term or permanent placement of hardware devices inside the body that are designed to deliver a specific type of treatment to the spine at regular intervals. Though these devices are permanent, they do involve regular maintenance for the refill of either battery energy storage or of specific types of narcotic medications.

Both of these types of devices have the job of disrupting pain signals before they reach the brain.

Neurostimulators involve the transmission of an electrical pulse to the spine to stimulate a tingling sensation at that level of the spine rather than pain and discomfort.

Intrathecal drug delivery systems, also known as drug pumps, involve the injection of analgesic pain medication to the fluid around the spinal cord. This also causes a disruption of the pain signal from reaching the brain. Because these medications are only required to act on small, specific areas of the anatomy, small doses are able to provide very large benefits, in terms of pain relief. This means that the doses required to provide significant pain relief are a small fraction of what patients would have to consume orally to receive comparable benefits.

Neurostimulators involve the use of a battery, wire leads, and sensor that that ends near the spinal cord. The hardwire is surgically implanted in the body. The device may be reprogrammed to send different intensities of energy and different timed intervals without requiring that the implantable device be removed surgically. The battery operated device may also be recharged without the device having to be surgically removed to be recharged.

How it works: Neurostimulator pain pumps transmit electrical pulses of energy to certain areas of the spine to inhibit the transmission of pain signals. Both the electrical pulses generated from the pump and the pain signals transmitted from our peripheral nervous system reach the brain for our brain to interpret. The difference between these two types of signals is that the energy from the pain pump arrives at the brain before the pain signals arrive. These early arrivals of neurostimulator energy before the pain signals have the effect our experience of pain relief. It has been said that the neurostimulator pump has the effect of outsmarting our brain.

This stopwatch sized device has a battery which stores the potential programmed to release certain intensities of energy at certain intervals of time. The device also has a computer microchip that allows users or doctors to be able to change these time and intensity settings from an external device, outside of your body. This ability to remotely change settings inside the device saves us from having to undergo new surgeries every time we want to reprogram the device. This ability to regularly change settings in minimally invasive ways makes it easy to continuously readjust the device regularly until we have arrived at settings that are effective at providing good back pain management.

Neurostimulators deliver mild impulses of electrical energy to the epidural space near your spine. Electrical wires, also known as leads, travel through the body to these epidural spaces. The electricity from these leads results in a tingling sensation rather than chronic pain, if it is able to achieve its intended results.

Many of these types of devices come equipped with handheld programmers that users may use at their homes and beyond to make setting changes on the fly. You may program these devices to change settings based on times of day and your activity levels. These devices may be programmed to respond to changes in body position, such as lying down, sitting, and standing upright. These devices may even be programmed to respond to changes in activity levels, such as walking, running, and occupational environments.

These neurostimulator systems have several components, including:
  • Neurostimulator - This is the device that includes both the battery and chip that enables us to be able to change settings from outside the body. This is the device that generates the electrical impulses. This device is implanted under the skin - usually in the upper buttock or abdomen.
  • Leads - The leads are wires and insulation over the wires that are threaded through the body to the epidural space.
  • Patient's programmer - the settings for this device may be adjusted from a hand held controller that is portable enough for the patient carry in and out of the house.
  • Physician's programmer - The settings for this device may be adjusted from a computer at the doctor's office.