FAQs
How do I know if neurostimulation will work for me?
Chronic pain involves both your mind and body. Your doctor will first perform a psychological assessment to determine if there are any psychological aspects of the pain that need to be treated.
Then your doctor will do a test to help decide whether neurostimulation will relieve your pain. Testing for neurostimulation can be done as an outpatient or you may be admitted for a short hospital stay. You will receive a local anaesthetic and then your doctor will carefully insert a lead through your skin via a needle into an area close to your pain, such as your mid-back.This lead will let your doctor adjust stimulation.
During the test, your doctor will ask you questions about the position and strength of the stimulation. This process will continue until the best place for reducing your pain is found. You will also be able to try out the system at home to make sure it works during your normal day to day activities. If you and your doctor agree the test has been successful you can have an operation to replace the temporary system with a permanent one. This will be fitted under your skin. People who do not experience adequate pain relief during the test will have the temporary system removed which leaves a small scar on your skin.
Will neurostimulation completely eliminate my pain?
Neurostimulation does not eliminate the source of pain but masks the pain signals sent to your brain, so the amount of pain reduction will vary from person to person. The test (as described above) will help your doctor decide if neurostimulation will work effectively for you. Neurostimulation requires commitment if you are to control pain. Learning to operate the neurostimulator and taking part in other treatments such as physiotherapy will help to ensure success. Typically the reduction of pain achieved is at least 50%.
What does neurostimulation feel like?
The sensation varies from person to person, but most report a tingling sensation in the area of their pain. Your doctor may refer to this tingling sensation as parasthesia.
Is neurostimulation safe?
Clinical research has shown that the tiny electrical pulses from the neurostimulation system are safe and do not damage the nervous system. Likewise, research has shown that the components are also safe.
Are there any side effects or problems with neurostimulation?
Side effects and problems such as headaches are rare and are only seen in a very small number of patients. Neurostimulation does require an operation and as with any operation there are some risks. These include infection, bleeding and pain.
Unlike some drugs used to control pain, neurostimulation does not cause drowsiness, disorientation or nausea. The most common problems that may be experienced with the neurostimulator include:
- No stimulation, resulting in loss of pain relief because a lead moves or other causes
- Intermittent (on-off) stimulation
- Stimulation in the wrong place
- Uncomfortable stimulation, described by some patients as shocking or jolting
- An allergic response to the system
- General programmer problems
- Threshold rise: Having to increase neurostimulator settings to achieve the same pain relief
Talk to your doctor about the possible side effects of neurostimulation.
Is the system comfortable and will people notice it?
The system does not make any noise. Most people report that it is not uncomfortable or restrictive, and does not interfere with their movements. The battery is unlikely to be visible through your clothes.
Will I experience any changes in sensation?
Some patients may feel more changes than others. In general the sensation of stimulation remains the same unless the underlying problem gets better or worse. Some people may feel changes in sensation with sudden abrupt movements or shifts in body position. Changes in stimulation are more common during the first few weeks after the operation.
How will I know when the battery on my system needs to be replaced?
Your doctor will be able to tell the state of the battery during regular check ups. When it is time to have your battery replaced, your doctor will remove your neurostimulator in a minor operation and replace it with a new one.
What safety precautions should I follow?
You can safely use most common household appliances, including microwave ovens, televisions, radio, remote controls and video games. The system can be affected by magnets or electromagnetic interference which might turn it off – but it can easiy be turned back on. Ideally you should avoid theft detectors, airport or security screening devices, large stereo speakers with magnets, high voltage power lines and electricity sub-stations and power generators. In addition, various medical procedures and equipment may affect the function of the system. These include CT scanners, magnetic resonance imaging (MRI), cardiac pacemakers, X-rays, ultrasound, defibrillators, diathermy and radiation treatment. For this reason, always tell any medical personnel that you have a neurostimulator.
Are there any special instructions for patients receiving neurostimulation?
Strictly follow your doctor's instructions about proper body positioning, lifting, twisting, bending, stretching and activity levels to minimise problems. Activities such as jogging, swimming, sex, cycling and tennis should pose no problems. Extreme sports such as skydiving that involve violent moments should be avoided as they might cause the lead or electrodes to move. It is also recommended that
you avoid extreme stretching or twisting in the first 6–8 weeks after your operation. This allows time for the lead to become fixed in place. It is essential that you keep all follow-up appointments as scheduled.
