FAQs on Spinal Cord Stimulation for Postherpetic Neuralgia
Spinal cord stimulation is considered the best way to ensure long-term relief from postherpetic neuralgia pain syndrome. Researches indicate 60% to 80% satisfactory neuropathic pain relief in patients using SCS therapy over an extended period.
What is postherpetic neuralgia?
Postherpetic neuralgia refers to neuropathic pain caused by herpes zoster or chicken pox virus. The virus 
infection is known to result in shingles or eruptions along a nerve path. This leads to severe spasmodic pain affecting the nerves. The sharp, aching, throbbing, shooting, or burning pain persists even after the shingles go away.
What are symptoms of postherpetic neuralgia?
- Mild to severe pain
- Pain continues for more than 3 months after shingles disappear
- Sharp, aching, throbbing, shooting, or burning pain
- Light and touch sentivity
What causes postherpetic neuralgia?
The chickenpox virus once enters your body, stays inside forever. With age and immune system becoming weak, it may reactivate itself. The virus damages nerve fibers that unable to carry on their normal functions. This leads to neurological confusion, spontaneous activity, and inflammation due to loss of sensory control and sets in chronic, excruciating pain.
How does spinal cord stimulation treat postherpetic neuralgia?
Postherpetic neuralgia cannot be cured. However, the pain can be reduced using various pain management techniques. Spinal cord stimulation acts like permanent “pacemaker for pain.” Electrical current delivered to the epidural space altered the ability of nerve fibers to carry pain sensation. Disruption of pain transmission provides excellent relief from postherpetic neuralgia.
How effective is spinal cord stimulation in managing postherpetic neuralgia?
Spinal cord stimulation is about 88% effective in significantly managing neuropathic pain. It also reduces the need for painkillers in 80% cases. A Korean study spread over four years found SCS therapy 82% effective in reducing pain from 9 to 1 on pain scale.
Italian researchers reported about 74% pain relief in 60% of postherpetic neuralgia patients underwent spinal cord stimulator implant. Another Chinese study has also established SCS therapy as an effective method to deal with the painful disorder.
What is spinal cord stimulation?
Spinal cord stimulation is a type of neuromodulation. A stopwatch-sized, battery-operated, and programmable device called spinal cord stimulator is implanted in the body of postherpetic neuralgia patients. It delivers electrical signals to the epidural area to interrupt pain signals.
Where is it implanted?
The spinal cord stimulator is implanted on the back of the abdomen just above the buttocks.
Who is a candidate for spinal cord stimulation?
Any one suffering from postherpetic neuralgia pain without relief from conventional treatments can go for spinal cord stimulator implant.
What are the components of a spinal cord stimulator?
A spinal cord has four components.
- A battery-operated, and programmable
- Electrode leads that deliver eclectic pulses to the epidural area
- A wire thread connecting both
- A remote control to operate and control spinal cord stimulation
What is involved with the spinal cord stimulator screening test?
Postherpetic neuralgia patients undergo a spinal cord stimulation trial prior to permanent implant. Local anesthesia is used to insert electrode leads into the epidural area. A wear connects the leads with the device patients externally wearing.
How long is the spinal cord stimulator trial?
Spinal cord stimulator trial goes on for a week. If the postherpetic neuralgia patients experience at least 50% pain relief, they are recommended for permanent implant.
How is the permanent spinal cord stimulator implant performed?
A postherpetic neuralgia patient is administered general anesthesia. Electrode leads are place close to the spine. The spinal cord stimulator is placed just above the buttocks using another incision. Wires connect the device with electrode leads. All functions of the unit are tested and incisions are closed.
What can I expect after the spinal cord stimulator implant?
Patients are kept under observation for about an hour and then discharged. Soreness at the surgery site continues for a few days. Postherpetic neuralgia pain relief starts from the day one, but stabilizes indicating the level of permanent relief from the fourth day onwards.
Keep the incision area dry and clean. Avoid intense activities, climbing stairs frequently, weight lifting, raising hand over head, running, swimming, and exercises for six weeks. No driving or sexual intercourse for four weeks.
Who should not have this procedure?
Those taking blood thinners or with neurological deficit or have anatomic spine instability must not go for spinal cord stimulation. Immunosupressed patients or those requiring future MRI test are also excluded.
Does spinal cord stimulation fix the source of postherpetic neuralgia pain?
No, it only helps manage symptoms for longer period and provide pain relief and improvements to quality of life.
What are the risks and side effects?
Overall spinal cord stimulation for postherpetic neuralgia is safe. However, implant may cause surgical complications unless you doctor is expert in performing it and it may lead to spine injury, nerve damage, scarring, and infections.
Is it covered by insurance?
Yes, insurers provide coverage for spinal cord stimulation for postherpetic neuralgia pain treatment subject to individual plans.
Premier Pain and Spine offers spinal cord stimulator implants at seven Chicagoland pain centers. The Award Winning doctors are first rate and most insurance is accepted. Call for top relief today for your painful condition!
References
Harke H, Ulrich L, Koester, P, et al. Spinal Cord Stimulation in Postherpetic Neuralgia and in Acute Herpes Zoster Pain. Anesthesia and Analgesia. 2002; 94, 695-700.
Baek IY, Park JY, Kim HJ, et al. Spinal Cord Stimulation in the Treatment of Postherpetic Neuralgia in Patients with Chronic Kidney Disease: A Case Series and Review of the Literature. Kor J Pain. 2011; 24(3), 154-157.
- Meglio, B. Cioni, A. Prezioso, et al. Spinal Cord Stimulation (SCS) in the Treatment of Postherpetic Pain. Springer Vienna. 1989; 45, pp 65-66
Liu M, Zhong J, Zhu J, et al. Treatment of Postherpetic Neuralgia Using DREZotomy Guided by Spinal Cord Stimulation. Stereotact Funct Neurosurg 2015;93:178-181
Moriyama K. Effect of temporary spinal cord stimulation on postherpetic neuralgia in the thoracic nerve area. Neuromodulation. 2009 Jan;12(1):39-43.