Cleveland Clinic Abu Dhabi introduces pain-relief therapy that uses nerve stimulation

Peripheral nerves are found outside the brain and spinal cord and extend to the organs and extremities. They control the functions of sensation, movement and motor coordination, and can be damaged easily. By using a small implant to deliver electrical impulses to the nerve, the PNS technique can significantly reduce pain for a number of conditions, including complex regional pain syndrome, foot pain, headache disorders, lower-back and neck pain, pain from a hernia or knee surgery and post-amputation or phantom limb pain.

“PNS is the newest, advanced option for pain management at CCAD. The minimally invasive nature of the implant and constantly advancing PNS technology make it a desirable method to manage pain in the right patient. It allows them to gradually reduce their reliance on medication, while also giving them superior, long-term pain relief,” said Dr Amar Salti, a staff physician in Anaesthesia and Pain Medicine at the hospital.

How it works

The PNS device consists of electrodes that are placed under the skin, close to where the pain originates. The patient first enters a trial phase where several nerve points are stimulated with low-frequency electrical impulses from a temporary implant until the nerve that is sending the pain signals is located. If the procedure shows results, the pain management expert programmes the stimulator to give the patient the best pain relief possible. The patient is provided with a remote device and instructions on how to control it themselves.

Medical assessment

PNS is recommended to patients with chronic pain after a thorough assessment of their medical history, and after identifying the source of the pain.

“There are various factors to consider before we recommend this treatment, including whether this is persistent pain. Patients who have not found adequate relief after 12 weeks of pain even on medication, and with other treatments, such as spinal cord stimulation, and physical therapy, may benefit from PNS. Patients see results instantly, and in six to eight weeks they can expect about a 50 per cent or more reduction in pain,” Dr Saiti said.

Patients treated

The first two patients who were implanted with the device in July for ankle and lower-leg pain at CCAD have already reported a significant improvement in their conditions.

“We never tell the patient that this treatment will rid them of the pain completely, but it allows them to manage it better. Imagine being unable to walk, drive, work, exercise or play with your children because of daily excruciating pain. We are now able to help these patients improve their quality of life through a simple, low-risk procedure,” Dr Saiti said.

The hospital also offers a range of multidisciplinary pain management treatments, which include non-addictive medication, physical therapy, psychology and interventional pain procedures. Last year, the hospital began offering the novel dorsal root ganglion stimulation treatment for patients suffering from focal neuropathic pain related to complex regional pain syndrome.