Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

New possibilities for pain management: the case for spinal cord stimulation

Bryan C. Hoelzer, MD
Conditions
November 16, 2021
Share
Tweet
Share

There’s one thing that links every patient I see as a pain management specialist: All they want is relief. And they want it in whatever way is going to be the most effective and least disruptive to their lives. And anyone in this role can tell you that that’s a big responsibility and a tall order. This job isn’t simply about reducing pain – it’s about giving people a life back that isn’t defined by that pain.

The fact of the matter is that many treatments we’ve relied on throughout the years to address chronic pain have come with major side effects or weren’t nearly as effective as they needed to be. The good news is that the last decade has seen major advancement in how we treat chronic pain. No one can deny that we’ve had to reconsider opioids as the first line of care of chronic pain. That reckoning has had a follow-on effect of increasing interest, excitement, and focus on pain management options that were otherwise ignored, like spinal cord stimulation (SCS) where an implanted device sends low levels of electricity into the spinal cord to relieve pain.

My first encounter with SCS came while I was a resident at the Mayo Clinic in the mid-2000s. At the time, it was only used for leg pain, but I was immediately taken in by the possibilities I saw. This was a very different approach to pain – it wasn’t simply about reducing it but in some cases, it could change the pattern of disease. On top of that, it was effective without the same side effects and stigma that come with opioids. The challenge though was that its use was limited to only a few conditions.

Those limitations felt a bit like a challenge. I immediately wanted to know just how else those of us in pain management might use SCS. And it turns out I wasn’t the only person asking these questions. A few years later, a company showed that they were able to use 10,000 Hz SCS to treat back pain. For SCS, this was a big moment – it was a completely new treatment modality, not simply a refinement on an existing treatment.

For me, this is what I’d been waiting for: here was evidence that this promising technology did have potential outside of leg pain. That potential is invaluable to me because as a physician – especially working with people living with chronic pain – the greatest thing I can give someone is hope. Being able to say that there is not just a treatment that works generally, but one that works for them in a way that lets them live their lives is why I do this job.

Right now, we have a chance to rethink how we provide pain relief because spinal cord stimulation is truly moving from being a last-resort treatment with limited indications to something with a far broader range of uses and applicability earlier in the treatment plan. SCS is more versatile than ever before – we can offer more types of stimulation that can dial in the right therapy for each patient.  Having those options means more chances to find relief that works.

And for patients, SCS offers some unique benefits. We’ve all seen the growing interest in remote care over the past year and a half, borne out of necessity from the pandemic. SCS therapy can now be optimized remotely, letting patients connect with doctors and company representatives to manage their pain from their own homes.

On top of that, the horizon for what SCS can be used for continues to expand. For instance, with their 10 kHz stimulation approach, Nevro recently received the FDA’s first specific indication for using SCS to treat painful diabetic neuropathy – a condition that was not even on the radar for SCS until recently. This sort of progress means we can also go back and look at patients we may not have been able to help in the past but who may be candidates for SCS now.

As practitioners, we deliver hope by being open to new ways and approaches to reducing and managing pain. Frankly, we should have been doing more of this work as the downsides of opioids came into focus. We should never expect to settle for “good enough” or continue doing something simply because it’s how we’ve always done it. We owe it to ourselves, our patients, and our colleagues to constantly question if there are better ways to deliver on the goal of reducing pain.

Bryan C. Hoelzer is an anesthesiologist and pain management specialist.

Image credit: Shutterstock.com

Prev

Why you should vaccinate your kids

November 16, 2021 Kevin 1
…
Next

Until next year, breast care center

November 16, 2021 Kevin 0
…

Tagged as: Pain Management

Post navigation

< Previous Post
Why you should vaccinate your kids
Next Post >
Until next year, breast care center

ADVERTISEMENT

Related Posts

  • A paradigm shift in acute pain assessment and management

    Myles Gart, MD
  • Using low-dose naltrexone to treat pain

    Alex Smith
  • Why staying ahead of your pain with opioids is the wrong advice

    Myles Gart, MD
  • 5 things I wish I had known earlier about chronic pain

    Tom Bowen
  • Suboxone for pain makes sense. Why don’t more doctors prescribe it?

    Hans Duvefelt, MD
  • How do we manage pain in the era of the opioid crisis?

    Rita Agarwal, MD

More in Conditions

  • Facing terminal cancer as a doctor and mother

    Kelly Curtin-Hallinan, DO
  • Why doctors must stop ignoring unintentional weight loss in patients with obesity

    Samantha Malley, FNP-C
  • Why hospitals are quietly capping top doctors’ pay

    Dennis Hursh, Esq
  • Why point-of-care ultrasound belongs in emergency department triage

    Resa E. Lewiss, MD and Courtney M. Smalley, MD
  • Why PSA levels alone shouldn’t define your prostate cancer risk

    Martina Ambardjieva, MD, PhD
  • Reframing chronic pain and dignity: What a pain clinic teaches us about MAiD and chronic suffering

    Olumuyiwa Bamgbade, MD
  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • Beyond burnout: Understanding the triangle of exhaustion [PODCAST]

      The Podcast by KevinMD | Podcast
    • Facing terminal cancer as a doctor and mother

      Kelly Curtin-Hallinan, DO | Conditions
    • Online eye exams spark legal battle over health care access

      Joshua Windham, JD and Daryl James | Policy
    • FDA delays could end vital treatment for rare disease patients

      G. van Londen, MD | Meds
    • Pharmacists are key to expanding Medicaid access to digital therapeutics

      Amanda Matter | Meds
    • Why ADHD in women requires a new approach [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • Beyond burnout: Understanding the triangle of exhaustion [PODCAST]

      The Podcast by KevinMD | Podcast
    • Facing terminal cancer as a doctor and mother

      Kelly Curtin-Hallinan, DO | Conditions
    • Online eye exams spark legal battle over health care access

      Joshua Windham, JD and Daryl James | Policy
    • FDA delays could end vital treatment for rare disease patients

      G. van Londen, MD | Meds
    • Pharmacists are key to expanding Medicaid access to digital therapeutics

      Amanda Matter | Meds
    • Why ADHD in women requires a new approach [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

New possibilities for pain management: the case for spinal cord stimulation
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...