Advancements in Chronic Pain Management: A Recap from Dr. Zack Smith

Dr. Zack Smith recently gave a presentation detailing some of the current advancements in treatment that may help patients struggling with long-term pain. You can watch the full presentation and Q&A above or on our YouTube channel, or continue reading for a summary.

Many people wait too long to seek help for chronic pain. If pain has lasted more than six months and is starting to interfere with your daily life—whether it’s walking, working, or enjoying time with family—it’s time to talk to a pain management specialist.

When you are seeking treatment for pain, you will likely go through what Dr. Smith refers to as a “ladder” of pain management options.

  1. Conservative care – Physical therapy, massage, chiropractic care
  2. Medications – Targeted drug therapies for nerve and mechanical pain
  3. Interventional treatments – For pain that doesn’t improve with other methods, treatments include surgery, as well as Radiofrequency Ablation and Spinal Cord Stimulation.

In the presentation, Dr. Smith focuses on two main treatments for chronic pain that has not responded to other treatments: Radiofrequency Ablation and Spinal Cord Stimulation. Both of these treatments use electricity to help try and treat nerve pain especially, but mechanical pain to varying degrees, but they use it in very different ways.

Radiofrequency Ablation (RFA)

RFA uses heat to disrupt pain signals in small sensory nerves. It involves using a specialized needle or probe and targeting the sensory nerves that actually tell our brain that we’re having pain and we burn them or “ablate” them. And it uses electricity, similar to how a microwave heats up your food. It actually heats up those little nerve endings and causes those nerve endings to die off.

It’s commonly used for joint or back pain and offers:

  • Up to 80% pain relief
  • Results lasting 12–24 months
  • Repeatable with minimal risk

Spinal Cord Stimulation (SCS)

SCS is a small device implanted near the spine that interrupts pain signals before they reach the brain. The technology has been around since the 1970s, but recent advancements in SCS have shown great improvements in both the efficacy of the treatment, as well as the type of chronic pain that is able to be treated with it. In addition to being previously recommended for lower back pain, SCS is now FDA-approved for the treatment of diabetic neuropathy, as well as other forms of neuropathy.

Today’s updated technology now allows patients to:

  • Control settings instantly via smartphone
  • Receive pain relief without the buzzing sensation that previous implants caused
  • Quicker pain relief after implantation

In order to assess if you are a good candidate for a spinal cord stimulator, you will begin with a trial:

  • The trial phase involves inserting temporary wires into your spine (like a test run).
  • You wear the device for about a week, connected to an external battery.
  • If you experience significant pain relief, you may be a good candidate for a permanent implant.
  • If you do not experience significant pain relief, the wires are removed, and there is no permanent hardware left behind.

SCS who underwent an SCS trial reported:

  • 80% success rates
  • 95% patient satisfaction

If you’ve tried other treatments and still live with pain, you may be a candidate for RFA or SCS. Visit pain.com to hear from real patients about their experiences with SCS, or schedule a consultation with Dr. Smith or another pain specialist to explore your options.

*The PainSmith team has reviewed this information. It is intended for informational purposes only, not to replace the advice of your doctor or other health care provider. Please discuss any questions or concerns you may have with your provider.

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