Pain is a perception by the nervous system. When a painful stimulus is applied to a body part, the nerve endings of that part will send the sensation all the way to the brain where it is perceived as pain. If the pain is experienced by the legs or hands, then the sensation travels via the spinal cord to be perceived as pain. In case of people suffering from nerve problems, there could be cases of chronic pain, therefore conservative treatment measures may fail at times. In these people, though the pain source cannot be reduced, the perception can be reduced. This is exactly what a spinal cord stimulator does, it masks the signals that are reaching the brain, and thereby reduces the perception of pain.
What is it and how does it work?
Spinal cord stimulator is implanted in patients with chronic intractable neuropathic pain when other conservative or surgical treatment has failed. Trial electrode/s are placed in the outer covering (epidural space) of the spinal cord, higher than the level of pain. Correct placement of electrode is confirmed by stimulating the electrodes through an external generator and different modes/intensity of current are tried to get best pain relief. Pain message is electrical in nature and reaches pain center in brain through multiple relays. Spinal cord stimulator converts electrical energy to a different feeling called neuromodulation and usually pleasant. Upon relief of atleast 60%, the device is implanted in the body like pacemaker for heart. An external remote device allows the device to be used when it is required. It is very safe and free from sideeffects of medications as no drug is used with this device.
Benefits of using stimulator
In case you have a concern or query you can always consult an expert & get answers to your questions!
One of the common ailments in elderly people is Parkinson’s. A progressive disorder, when left untreated, results in worsening of the symptoms. Hence, it is essential to understand the treatment options available to manage the condition effectively. You may be suggested surgical therapies if medication is not effective enough to treat the symptoms.
Surgical treatment options can be beneficial for patients who are suffering from symptoms, but they do not help with treating the disease. In the past, surgical methods like Thalamotomy and Pallidotomy were used to destroy brain cells that contributed to the symptoms. While these methods are still used, they are very rare and situational.
Deep Brain Stimulation (DBS), an FDA-approved procedure, has become much more popular as it is much safer and does not involve invasive surgery. Instead of destroying brain cells like traditional methods, DBS involves sending electric pulses to the affected brain cells to reduce the symptoms. It is not a treatment procedure, but a means of bringing down the severity of Parkinson’s to allow better and more comfortable treatment.
Deep Brain Simulation – Who are the right candidates?
Deep Brain Simulation is commonly used for Parkinson ’s disease, but it is not recommended for everyone. It is a preferred method of treatment for people who have had Parkinson’s for at least four years but have complications which include long periods of time where medications do not work, or symptoms return, uncontrolled and involuntary movements or the freezing/stiffness in the body.
Deep Brain Simulation is not recommended for those who have Dementia as it can lead to memory problems. The general rule of thumb that neurosurgeons follow is that Deep Brain Simulation can help with symptoms that do not get better with medication. DBS can help reduce medication requirements for patients as well as reduce the side effects that may occur due to medication.
Disorder specialists and neurosurgeons can conduct tests to determine if DBS is going to be effective for a patient before going ahead with such a procedure. An extensive assessment is necessary to understand the symptoms, the effect of Parkinson's drugs and also brain imaging is done. All of the expected benefits are then evaluated for the patients, and if the procedure can help alleviate the symptoms, DBS is given a green signal by neurosurgeons and patients can undergo the procedure.
How Does Deep Brain Simulation Work?
Deep Brain Simulation is a very complex procedure. Brain cells communicate with the rest of the body through an electric signal and these become irregular and do not work properly when affected by Parkinson's. DBS smoothens the functioning of these brain cells and reduces symptoms through electric pulses through the implantation of a medical device known as neurostimulator which is also referred to as brain pacemaker.
But, as with any treatment procedure, DBS has potential risks and side effects, hence discuss with neurosurgeon thoroughly to access the suitability.
Nerve pain or peripheral neuropathy, as it is medically known, is characterized by pain, numbness and weakness that arise out of nerve damage. This pain is usually restricted to the feet and the hands.
What are the common causes?
Diabetes is the most common cause for this condition. However, other causes, such as injuries, infections and prolonged exposure to certain toxins can also trigger nerve pain.
How can you control nerve pain?
Nerve pain can be managed and taken care of at home taking into consideration the points that have been mentioned below:
Topical Painkillers: Certain over the counter ointments and creams can help relieve nerve pain. These medications act as local anesthetics; that is they numb the area of the pain. Capsaicin, a derivative of chili peppers, is one of the major ingredients used in these medicines. Others use botanical oils as the major ingredients.
Supplements: The lack of Vitamin B12 is considered to be a very important cause, and at times, a catalyst for nerve pain. In a case such as this, Vitamin B12 supplements or injections might be administered. Although more research needs to go into this, but certain supplements, especially gamma-linolenic and alpha-lipoic acid can help soothe nerve pain caused by diabetes.
Acupuncture: This time-honored Chinese approach is a proven alleviator of nerve pain. Acupuncture releases chemicals which numb the pain, or prevent the pain signals from travelling to the brain.
Physical Therapy and Massages: Physical Therapy can especially heal and strengthen weak muscles that can stem from acute nerve damage and pain. Though more evidence is needed, according to a few sufferers of this condition, massages can be helpful with the tremendously painful muscle spasms that can so often result from nerve pain.
Relaxation Techniques: In combination with the abovementioned approaches, relaxation techniques can go a long way in relieving debilitating neural pain. Besides being helpful with dealing and reducing a few stress phases of life which can cause nerve pain, these techniques might actually root out the actual pain itself.
Lifestyle Modifications: This one’s always a winner! Eating a well-balanced diet that guarantees all nutrients in uniform amounts can never go wrong. Regular exercises for about 30-45 minutes can remedy different types of pain; nerve pain being one of them. Try and limit alcohol intake (a peg once a week won’t harm one, but binge drinking can play the ultimate spoilsport and make all health plans go topsy-turvy!). Abstain from smoking or chewing tobacco as this is usually the primary contributor towards any medical condition or disorder. If you wish to discuss about any specific problem, you can consult a neurologist.
Pain management is an issue that stares back at mankind, irrespective of the underlying health condition. Whether it is a headache or a back pain, burn or fracture, heart attack or cancer, pain is always a symptom. In some cases like migraines, cancer, etc., the pain is chronic and the patient needs to be constantly on the vigil to know when an attack will ensue. This has also put high pressure on the medical fraternity to identify ways that can provide relief to these people. Various methods have been identified, and one of them is the electrotherapy.
What is done?
A few electrical impulses are directed at the area of the pain using a hand-held device. This is similar to providing electric shocks of mild intensity to the affected area (forehead, low back, neck, etc.). What this does is stimulate the nerve endings, improves circulation and muscle strength and promotes bone growth and tissue repair. The end result of all this is overall improved functioning and pain relief. Depending on the actual condition, the sessions will have to be repeated. In some patients, the electrotherapy is used in conjunction with other therapy so that they can go about their routine exercise and pain relief.
The sessions may also have to be repeated as most often these are used in individuals with chronic pain. They are also helpful in providing relief during the acute attacks.
How does it work?
The most common form of electrotherapy is known as TENS, which stands for transcutaneous electrical nerve stimulation. The area to be treated is cleansed with spirit and then small sticky pads are applied through which the electricity is passed. A hand-held device is used, through which electrical impulses are passed to the skin, which stimulates the nerve cells to provide relief from pain. It causes a vibrating and tingling sensation in the treated area. It is believed that it blocks the nerve impulses and therefore provides pain relief. Another theory states that they promote the release of endorphins which are natural painkillers; it is also very effective in case of migraine and sciatica and neck pain where the chronic pain is coupled with acute spurts.
With narcotic painkillers having various side effects, techniques like electrotherapy are gaining popularity. A small catch also is that it does not work for everybody and in most people with back pain, fibromyalgia, and migraines, requires repeat sessions for relief. The cost of each session also needs to be considered against the extent of relief achieved. However, for those whom it works, it is a very good technique for chronic pain control.
A pinched nerve is a sensation that causes a lot of pain due to pressure on the nerve or some form of nerve damage that may have been caused due to an accident, sports injury, or even as a side effect of other chronic conditions like diabetes. In this condition, one experiences a sharp and shooting pain as soon as there is some movement of the area or pressure on the same.
A pinched nerve usually signifies damage rendered to a peripheral nerve which is usually to be found outside the spinal cord and the brain. Disc herniation and arthritis are also some conditions that may cause a pinched nerve in the affected area. This happens due to the pressure on the nerve which may lead to irritation in the protective layer of the same. This condition can make life quite painful. So here are a number of ways in which you can manage the pinched nerve.
If above conservative treatment fails then we have to go for interventional pain management. Interventions can range from simple trigger point injection, inter lesional injections to more advanced rhizotomies, radio frequency ablation, neurolysis, etc.
Brain Surgery for treating Parkinson's diease is called Deep Brain Stimulation, or DBS.
If your symptoms are well controlled with medications, no doctor in their right mind would recommend you to have surgery. But in a few patients, medications no longer is pushed into a very particular part of the produce adequate improvement. Either the improvement lasts for a very short time, or the medication produces such dramatic dyskinesias that giving an adequate dose is impossible. Approximately, 70% of such patients benefit kept in the skin below the chest. No part from this surgery.
The improvement is very significant, but DBS does not make all symptoms of Parkinson’s disease magically disappear. It is very important to have realistic expectations from the surgery. The improvement seen after surgery is not the same for every patient. On an average, patients get 5 extra hours of good functioning during which time they can walk, talk, go around and – in general – have a better life. The 5 “good” hours may not seem like much. But when you consider the fact that these patients frequently don’t even have 4 hours of good functioning before the surgery, it represents a major improvement in their quality of life.
DBS SURGICAL PROCEDURE - how is this surgery done?
This is a brain surgery, but a relatively minor one. A metal frame is usually attached to the patient’s head. A very small hole (approximately 1 cm in diameter) is made in the head, and a thin (1 to 1.5 mm thick) wire is inserted through it. The wire brain called the “sub-thalamic nucleus”.
The same process is repeated on the other side and another small wire is inserted. These wires are then connected to a small battery (a square of approx. 3 inch) that is of this device can be seen from the outside, and any scars on the head are usually covered by hair in a few weeks.The device is usually turned on 4 weeks after the surgery. On an average, most batteries last about 5 years, and can be replaced when required. Consult an Expert & get answers to your questions!
Cochlear implant is a medical device that provides direct electrical stimulation to the hearing nerve in the inner ear. Children and adults with a severe hearing lossmay be helped with cochlear implants. A cochlear implant is a prosthetic substitute directly stimulating the cochlea and it does not cure deafness or hearing impairment.
A cochlear implant completely by-passes the normal hearing mechanism and stimulates the auditory nerve directly by means of an internally implanted electrode assembly. The implant consists of an external portion that located behind the ear and an interior portion which is surgically implanted under the skin. An implant has a microphone, a speech processor, a transmitter and an electrode array. The sound from the environment is picked by microphone and transmitter and receiver/stimulator sends them to speech processor to convert them into electric impulses.
The speech processor placed with the microphone behind the ear, or it is a small box-like unit worn in a chest pocket. The speech processor digitizes the sound signals and sends them to a transmitter just behind the ear. The electrode array collects the impulses from the stimulator and sends those to different regions of the auditory nerve. The electrodes stimulate the fibers of the auditory nerve, and sound sensations are perceived.
A cochlear implant is very different from a hearing aid. Hearing aids amplify sounds so that they can be detected by damaged ears. Cochlear implants bypass damaged portions of the ear and directly stimulate the auditory nerve. Hearing via a cochlear implant is different from normal hearing and takes time to adjust. However, it enables many people to understand other sounds in the environment, recognize warning signals, , and understand speech in person or over the telephone.
The benefits from a cochlear implant depend on many factors, such as the age of the patient when he or she receives the implant, the hearing loss present pre or post patient developed language skills and finally the motivation of the patient and family support
Once a person is referred for cochlear implant, more testing is done which includes audio logic testing, psychological testing, medical examination, and tests performed by the surgeon. It is done to ensure that the candidate will benefit from a cochlear implant and will have the motivation to participate in the process. Once the decision is made to go ahead, the surgery is done. Sometimes it involves an overnight stay in the clinic, and sometimes it is done on an outpatient basis. Six weeks post-surgery, patient is fitted with the external microphone and speech processor and implant is activated and programmed.
The best candidates are those having severe hearing loss in both ears, limited benefit from hearing aids, medical condition that makes surgery risky. Children can be considered for cochlear implants if they have the similar conditions as adults and in addition have support from their educational institutions to development of auditory skills.
Traditionally, people resort to hearing aids in order to take care of their auditory problems. The perception of hearing reduces as age progresses and people find it absolutely necessary to come up with ways by which they can improve their hearing. However, cochlear implants have become extremely popular because of the method that it uses in comparison to the traditional methods of hearing aids.
What is a cochlear implant?
A cochlear implant is an electronic medical device that replaces the function of the damaged inner ear. Unlike hearing aids, which make sounds louder, cochlear implants bypass the damaged hair cells of the inner ear (cochlea) to provide sound signals to the brain.
Who can they help?
The cochlear implant technology can help people who:
Many people have cochlear devices in both ears (bilateral). Listening with two ears can improve your ability to identify the direction of sound and separate the sounds you want to hear from those you don’t.
What are the benefits of a cochlear implant?
Many adults with cochlear implants report that they:
How is a cochlear implant different from a hearing aid?
A cochlear implant is very different from a hearing aid and is appropriate for individuals for whom hearing aids fail to provide benefit. A hearing aid makes sounds louder. Sound still travels through all the portions of the ear (outer ear, middle ear, inner ear) to the hearing nerve. A cochlear implant bypasses these structures and directly stimulates the hearing nerve with electrical energy. Because hearing aids amplify sounds and rely on the hearing system to convey the message, people with severe to profound hearing loss may be able to hear, but not understand speech well. The main objective of a cochlear implant is to improve speech understanding in quiet. Clarity with a cochlear implant is usually better than a hearing aid because the implant does not make sounds louder but delivers them to the hearing nerve.
There are a number of symptoms, which people should be looking out for before concluding that they have a hearing disorder:
If you wish to discuss about any specific problem, you can consult an ENT specialist.
Overactive bladder, also known as OAB, is a condition where sudden involuntary contractions of the urinary bladder's muscular walls cause bladder storage dysfunction. It leads to sudden and frequent urges to urinate (urinary urgency), as well as unintentional leakage or urine (urinary incontinence).
This is a condition that affects both men and women and causes tremendous discomfort in nearly every aspect of daily life. The specific causes of OAB vary from case to case but it is generally attributed to infection of the urinary tract or dysfunction of the nervous system. The symptoms are intensified by unhealthy lifestyle choices such as overindulging in caffeinated drinks, spicy foods and alcohol.
There are several ways in which you can deal with the problem of OAB, depending on the nature of the case. It is necessary for you to consult a urologist for a detailed diagnosis to formulate the best treatment option.
Following are the most effective remedies to treat an overactive bladder:
1. Lifestyle Modifications: Also known as behavioral therapy, this is the first step in the treatment of OAB. It involves inculcating simple changes into everyday habits such as avoiding food and drinks that irritate the bladder, scheduling (and in some cases, practice delaying) bathroom visits, exercising the pelvic floor and bladder muscles, keeping a record of urinating habits in a 'bladder diary' for better understanding the problem, etc. You can incorporate these habits into everyday activities for an easy alleviation of the problem with absolutely no side effects.