Dorsal Root Ganglion (DRG) Stimulation

Not only is it frustrating to live with chronic pain, the situation becomes even more dire when no relief can be found. This could be due to the fact that diagnosis is difficult to determine, making treatment options difficult to prescribe and successfully render. Thankfully there is a relatively new method called dorsal root ganglion stimulation, which has proven to finally offer patients who are suffering from complex regional pain syndrome in the lower extremities with relief. The California Pain Consultants team in the Escondido, El Centro, La Mesa, San Diego, and Chula Vista areas are able to help their family of patients finally find the long-term relief they need to enjoy their standard quality of life without having to suffer through painful days and nights. 

What is Dorsal Root Ganglion Stimulation?

A dorsal root ganglion (DRG) stimulation is an advanced procedure for treating complex regional pain syndrome (CRPS). It has proven helpful in providing pain relief for patients who are suffering with complex pain conditions who haven’t been able to find relief, including:

• Complex regional pain syndrome
• Post-amputation phantom and stump pain
• Failed back surgery syndrome
• Lower abdominal and visceral pain
• Groin and testicular pain
• Chronic, refractory and post-surgical pain
• Diabetic neuropathy

The reason why dorsal root ganglion stimulation is so successful is because it provides a targeted and custom-fit approach to treat the exact nerve or nerves that are causing the patient to feel pain, which has proven extremely helpful for complex conditions. 

The dorsal root ganglia are nerve structures located in the spine, of which there are many and each structure is responsible for sensation signaling in a different area. Within each structure are primary sensory neurons, which are neurons primarily responsible for pain signaling. Dorsal root ganglion stimulation works by targeting the specific nerve responsible for pain in a specific area and treating only those nerves. 

Treatment involves using a small implanted device under the skin close to the involved dorsal root ganglia. The device sends a mild electrical current that essentially stops the targeted nerve from sending pain sensations to the brain, instead replacing the sharp or burning pain with a tingling or buzzing sensation. 

What is the Difference Between DRG and Spinal Cord Stimulation?

While both options use a mild electrical current via an implanted device to replace pain sensations, there are some significant differences. 

The spinal cord stimulation (SCS) device is implanted into the epidural space in the spine and treats a variety of nerves with a goal to reach the nerve that is causing pain sensations but not specifically pinpoint the nerve itself. Another drawback is that the leads can shift if the device moves from its intended position, which could happen if the person is sitting in an awkward position or performing an exercise. 

The main difference with dorsal root ganglion stimulation is that it can target specific nerves thought to be causing pain, as well as reach nerves that SCS misses, especially in the lower extremities. While SCS is great for managing widespread pain, DRG is particularly helpful for providing relief for the specific area that hurts. Also, due to the implant location, there is very little chance that the device will shift, so there is minimal opportunity for a lapse in pain-relieving sensation. 

How Does Dorsal Root Ganglion Stimulation Help with Complex Regional Pain Syndrome?

Complex regional pain syndrome (CRPS), also known as reflex sympathetic dystrophy (RSD), is a complex syndrome to both diagnose and treat. The reason being is that where pain is felt is not necessarily where the source of pain originates. This is what makes dorsal root ganglion stimulation so effective because once the particular nerve is targeted, it can be treated. 

CRPS generally occurs in the lower or upper extremities and is described as constant and intense pain. In addition to the most common symptoms, which include swelling, severe and burning pain, increased sensitivity to painful stimuli and sweating, the symptoms can also spread. This means that even if an injury occurred in the left leg, pain sensations could be felt in the right arm or opposite leg. 

Because the cause of CRPS is not always identifiable, general treatment methods, which include blocks and medications, fail to provide either complete relief or long-term relief. The benefit of dorsal root ganglion stimulation is that it provides both short- and long-term effective pain relief for pain conditions that affect the lower extremities. 

What Does Dorsal Root Ganglion Procedure Involve?

The procedure itself is done in two phases: a trial period and, if effective, a permanent implantation appointment. Both of these are out-patient procedures. 

During the trial period, a pain management specialist will provide light anesthesia before placing the trial stimulator leads into the epidural space with a goal to stimulate the targeted dorsal root ganglia. The provider will then send a mild electrical current through the leads to ensure that the patient feels the tingling sensation (versus pain). If this is effective, the patient will wear an external device that allows them to control the level of current and subsequent pain relief for about a week. 

If the trial period proves successful, the patient will receive a permanent dorsal root ganglion device, which is implanted in the buttock or abdomen and is controlled by the patient with an external controller. The entire procedure takes about an hour and the patient will be trained on how to use the controller to best manage their level of pain. The stimulation does not eliminate what is causing the patient’s pain, but does change the way the brain perceives the pain. Most patients experience long-term pain relief with or without the associated tingling sensation. 

If you are suffering from complex regional pain syndrome and are experiencing pain in the pelvis, groin, hips, knees, ankles, and feet that other therapy methods have failed to treat, a dorsal root ganglion stimulation might be the treatment you’re looking for. Please schedule an appointment today with the California Pain Consultants team in the Escondido, El Centro, La Mesa, San Diego, and Chula Vista areas and start looking forward to pain relief tomorrow.