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Cleveland Clinic Abu Dhabi

Abu Dhabi: A new nerve stimulation therapy that can relieve chronic pain in the lower body is now available at Cleveland Clinic Abu Dhabi.

DRG stimulation therapy works with a small device implanted in the spine that stimulates the dorsal root ganglion (DRG), a structure densely populated with sensory nerves that transmits information to the brain through the spinal cord. The device then allows for targeted pain management.

The therapy is approved by the US Food and Drug Administration for causalgia — a severe burning pain in the limb caused by injury to a peripheral nerve — and neuropathic pain in the lower body, including in the foot, knee, hip or groin. It is currently only available at the Abu Dhabi-based hospital in the UAE.

Pain management

In a statement, the hospital said the newly-available therapy is recommended for patients who have failed to receive sufficient pain relief and quality of life improvements from other conventional treatments, including medication, nerve block, physical therapy and conventional spinal cord stimulation. This is done after a complete analysis of the patient’s history and current health conditions by the multidisciplinary pain management team at the hospital.

First patient experience

Abu Dhabi resident Jonathan Rogers, who has had pain since a weightlifting injury from three years ago, has become the first patient in the UAE to receive the treatment. “It began with a fractured bone in my foot and even after that healed the excruciating pain continued and was getting worse. It got so bad that during a return flight from a work trip, I blacked out because of the pain,” the 36-year-old patient said. “I have had to give up a lot of things that I used to enjoy, like playing street hockey, lifting weights or going to the beach. I have been unable to travel for more than two years now and have had to avoid loud locations because the noise and vibrations worsen the pain,” he added.

Rogers has been working with Cleveland Clinic Abu Dhabi’s neurology and pain management team since 2018. “The various treatments that I have been on have done little to alleviate the pain and it spread to the entire leg. Only now am I beginning to see improvements in my mobility and pain levels because of the addition of DRG therapy,” Rogers said.

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Important milestone

Dr. Reda Tolba, chair of the Pain Management Department in the hospital’s Anesthesiology Institute, trained in the United States to perform the DRG therapy. He explained that a lot of patients who undergo surgeries for hernial repair, foot injuries and knee replacement end up with neuropathic pain. “This can be debilitating and makes even simple, daily activities hard to carry out. The availability of DRG stimulation therapy in the UAE marks an important milestone in the treatment of chronic intractable pain conditions,” he said.

“This sophisticated therapy [also] brings much-needed relief to patients suffering from focal nerve pain due to complex regional pain syndrome, a painful condition casing debilitating pain over the extremities and other parts of the body,” Dr Tolba added.

Trial phase

Before the permanent implantation of the device, done through an ambulatory surgery, the patient goes through a trial phase for a week where the device is placed externally to assess its effectiveness in reducing pain.

Although the device was implanted very recently, Rogers says he has witnessed up to 50 per cent reduction in pain. “The biggest improvements are in the small actions that make up a big part of my daily life. It is easier to stand up; I can sit in a chair without struggling and I feel safer while standing,” he said.