Living with chronic pain: Neurostimulation as a treatment option

Chronic pain is pain that lasts or recurs for longer than 3-6 months, even after the original cause has healed. Over time, the body develops what is known as pain memory: pain signals are "overlearned" by the nervous system – meaning that nerves and the brain become increasingly sensitive to pain stimuli over time. Those affected can feel pain even though there is no longer an acute trigger.

Typical forms of chronic pain:

• Back pain
• Nerve pain (neuropathies)
• Phantom pain
• CRPS (complex regional pain syndrome)
• Pain after surgery or herniated discs

Treatment is usually multimodal, i.e., combined. Typical components:

• Painkillers (e.g., NSAIDs)
• Neuropathic pain medication (anticonvulsants, antidepressants)
• Local anesthetics & injections

• Targeted exercises to strengthen muscles
• Posture training
• Manual therapy

• Cognitive behavioral therapy to manage pain behavior
• Mindfulness and relaxation techniques (autogenic training, progressive muscle relaxation)
• Biofeedback

• Nerve blocks
• Radiofrequency therapy
• Implantable pumps

If these measures are not sufficiently effective, neurostimulation may be an option.

A neurostimulator (colloquially also known as a "pain pacemaker") can be useful for chronic pain if:

• the pain has persisted for at least 6 months,
• other forms of therapy have not provided sufficient relief,
• the pain is nerve-related (neuropathies, sciatica, pain near the spinal cord, CRPS, post-operative pain, etc.),
• patients are willing to use a technical aid that can be permanently implanted in the body (in the case of invasive stimulation).

For many patients, neurostimulation is a way to

• significantly reduce pain,
• reduce medication and thus side effects,
• regain quality of life.

In many cases, a short trial period – known as trial stimulation – can help to decide whether a neurostimulator is suitable in the long term.

Neurostimulation encompasses a wide range of procedures – from TENS devices for home use to implantable neurostimulators that can be customized.

What does living with a neurostimulator mean in everyday life?

• Most patients hardly feel the implant after healing.
• Modern systems are MRI-compatible (depending on the device).
• Depending on the model, the battery life ranges from 3-10 years.
• Patients control their stimulation via an app or remote control.
• Many report:
  • better sleep quality
  • higher resilience
  • less need for medication
  • more everyday activity

Chronic pain is complex – but modern therapeutic approaches such as neurostimulation for chronic pain open up new possibilities for many sufferers. Many patients find it helpful to know that there are other effective treatment options besides medication.

Which treatment is suitable in each individual case can only be determined in consultation with medical professionals. If you have been suffering from pain for a long time, talking to a pain therapist can be an important step toward finding new ways to relieve it.