Chronic Pain Relief

By Silvia Wilson

"Well, Mrs. Wilson," Dr. H., an eminent neurosurgeon, said to me after performing a laminectomy-nerve root exploration at L4-5 and L5-S1 without success, "we won’t know the cause of your back pain until we do your autopsy."

I was devastated. I was also very, very angry, and more determined than ever to somehow, somewhere, get relief from the chronic pain which had turned my life upside down for the past three years.

I had finished my university degree "With High Distinction" four years earlier as a mature student, and had been working at the Career Counselling Centre at the University of Toronto. Life could not have been better. Then, disaster struck. I had had minor back problems for many years, and one day, while getting ready to go to work, I felt a crunch in my lower back, followed by a shooting pain down my left leg and a feeling as if my calf and foot were on fire.

I could just barely make it to the phone to call for help before I passed out with pain. I was taken to hospital by ambulance, put in traction and told that, due to a herniated disc, I would have to stay there for at least two weeks.

"Two weeks!" I exclaimed. I didn’t have that much time!

Those two weeks turned into three years of unabated pain. Investigative procedures, including X-rays, two myelograms, a discogram and a CT-scan, were carried out. Non-invasive procedures such as bed rest, wearing a corset, heat applications, physiotherapy, TENS (transcutaneous electrical nerve stimulation), ultrasound treatments, acupuncture and cortisone injections brought no lasting relief. A chymopapain injection only increased the leg pain. Surgery -- a laminectomy, discotomy and laminectomy-nerve root exploration -- did not improve my condition.

My condition during those three years was such that I was unable to walk around the block, be in the car for more than half an hour, either as a passenger or driver, or sleep more than two hours at night. Sitting was very painful due to intense back and sciatic pain, numbness, tingling and severe cramps in my left foot and calf. I could no longer work at my job. I could no longer take part in any family activities, visit my parents in Switzerland -- or travel anywhere else, for that matter. I could no longer ski, swim, play tennis or go hiking. I could no longer attend any functions, concerts, plays or movies. I could no longer ask friends over for dinner. The list of "no longers" goes on and on. I used all my energy trying to cope with the pain. That pain was controlling my life completely.

My family doctor suggested I was depressed and that this depression worked like an amplifier of my pain. This "it’s all in your head, dear" approach was the final straw. I wondered whether he expected me to sing and dance for joy! However, he did refer me to a doctor specializing in acupuncture treatments combined with a slight electric current going through the acupuncture needles. For the first time in years, I actually experienced some pain relief. Unfortunately, the relief only lasted while the current was applied; there was no residual relief, as the doctor had hoped for. Nevertheless, this was a first glimmer of hope.

After the verdict by this neurosurgeon, I did some "market research" and discovered that Dr. Vanderlinden used a procedure that had been successful in certain cases of chronic pain. On my insistence, my family doctor referred me to him.

Dr. Vanderlinden was confident that spinal cord stimulation (SCS) might help me. He felt that my unrelenting pain was the result of nerve root scarring due to the severe disc herniation I had experienced three years before. SCS, he explained, was a form of nerve stimulation that used tiny electrical pulses to block the pain messages to the brain. Ideally, stimulation would create only a slightly tingling sensation in the area where pain was usually felt. SCS implantation, a reversible surgical procedure, consisted of a trial screening to determine if stimulation would cover the pain, and then, if it was successful, the implantation of the permanent system. I could hardly wait!

The trial proved quite successful, inasmuch as stimulation did cover the pain, but the sensation of stimulation changed considerably with movement and shifts in posture. The permanent system was implanted and, after some getting used to, I found that I had the best relief when using the SCS system for about a half-hour while lying down. I would then experience residual relief for some time, which was an invaluable benefit for getting a good night’s sleep. Finally, I was in control of my life again!

Over time, I used SCS less and less frequently. The pain slowly and almost imperceptibly became intermittent. Later on, when the SCS system broke down and either had to be replaced or "explanted," as Dr. Vanderlinden called it, I was actually able to say, "Let’s see whether I can fly on my own!" Dr. Vanderlinden’s theory to explain this happy situation was that, in some people with chronic pain, the pain signal transmitters go haywire and transmit pain signals constantly. In some cases, through SCS, the pain signal transmitters are put back on track, reducing the need for electrical stimulation. I was one of those people.

Now I only feel pain occasionally, for instance when there is a sharp drop in temperature, when I am sitting for a long time, or when I don’t observe the "do’s" and "don’t’s" for people with back problems. And there is the added security blanket of knowing that, should chronic pain return, SCS is available.

My quality of life has improved dramatically. I am working from my home as a translator in four languages. I am able to travel, swim and cross-country ski again, and lead a normal and full life. I shall forever be grateful to Medtronic and Dr. Vanderlinden.

(For more information on the Medtronic Spinal Cord Stimulation implant and its applications, contact Medtronic of Canada, 6733 Kitimat Rd., Mississauga, Ontario, L5N 1W3, (905) 826-6020.)