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  • Alexander Kiefer, MD

A New Cutting-edge Therapy for Difficult to Treat Pain

In Greek Mythology, the mortal Sisyphus was condemned to an eternity of rolling a boulder uphill and then watching it roll back again -- day after day. During many conversations with my patients, I often hear that they feel they suffer a similar fate. Just as they begin to see some progress with their painful condition, they feel that progress start to slip away, back down the hill – just like the Greek myth. This can be demoralizing as persistent chronic pain affects all aspects of one’s life: personal relationships, career advancement, self-image, leisure activities, and even religious beliefs.

Fortunately, there are many therapies that can help patients live happier and more fulfilling lives. Occasionally, however, a patient’s pain might continue even after trying all of the therapies available. For these patients, I look to new technologies and cutting-edge therapies.


An exciting development in the field of pain medicine is a new technology called a Dorsal Root Ganglion (DRG) Stimulator. The Dorsal Root Ganglion (DRG) is a part of the nervous system that acts like a gatekeeper for pain. When a person stubs their toe, that painful sensation travels along a nerve, up their leg, to the DRG in their back. As the gatekeeper, the DRG can either stop the pain in its tracks or it can allow the pain to travel through the gate and travel up the spinal cord to the brain. When the pain gets to the brain, the person knows that they have stubbed their toe and it is painful. If the pain signal is not allowed through, the person will never feel the pain.


An interesting aspect of the DRG, however, is that it not only can allow or prevent pain from passing to the brain, but it also can also decrease or increase the level of pain. In fact, in many patients with chronic pain, the DRG is actually malfunctioning by constantly increasing the pain dramatically before it gets to the brain, turning a whisper of pain into a shout. So, sensations that shouldn’t be painful become painful; pain that should go away naturally over time continues. Sometimes a non-painful sensation – like a bed sheet lightly touching your skin -- can be instantly changed into excruciating pain by this malfunctioning nervous system.


Fortunately, there is now the DRG stimulator, designed to stop this type of malfunctioning. The DRG stimulator is a very thin wire that is placed over the DRG during a minimally-invasive outpatient procedure, which takes only about 45 minutes. It stimulates the DRG using a very small current, which is not felt by the patient. This stimulation can stop a malfunctioning DRG from increasing the pain before it gets to the brain, stopping the pain in its tracks. Before deciding whether this stimulator is the right fit, a patient can actually try it for 5-7 days without surgery or a hospital stay.


Many patients who previously had untreatable pain can now find some relief without dangerous opioids or other medications. Patients who have been diagnosed with Chronic Regional Pain Syndrome (CRPS) or have suffered a nerve injury can often see significant improvement. Other conditions that can be treated include knee pain after knee replacement, hip pain after hip replacement, groin pain, pain after hernia repairs, stump pain, and phantom limb pain. Patients may benefit from this therapy even if they haven’t from a traditional spinal cord stimulator.


If you are suffering from chronic pain, please be reassured that there are safe, effective, convenient, and minimally invasive therapies available.


Schedule an in-office pain evaluation at Georgetown Pain Management to assess if this or other therapies may be helpful for you and improve your life. Most insurances are accepted and new patient evaluations are currently being scheduled.


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