'It gave me my life back': Spinal cord stimulation can ease pain, but access is limited
Patient says the device let her dance again — and get off morphine
For Rebecca Clements, 55, pain became a big part of her life when she injured her back at age 14. Two rounds of surgery helped, but when she was in her 20s, a couple of car accidents led to more pain.
Clements, who lives in the northern Okanagan city of Vernon, B.C., tried whatever she could to manage the severe, chronic pain in her back that later extended down her leg — there was physiotherapy, massage and acupuncture.
In 2006, the pain caused her to quit a job as a cashier and three years ago she took a dramatic turn for the worse. Clements was rendered immobile while her husband cared for her for more than three months.
With help from her local doctor, she began relying more and more on medication, namely opioids like morphine. But there was always a fear that could take her down a troubling road.
"The last thing you want to be is addicted to drugs," said Clements.
Then she was referred to the Interventional Pain Clinic at St. Paul's Hospital in Vancouver where earlier this year she received a spinal cord stimulation implant in her back.
The technology isn't especially new, but it was new to Clements — and a major relief.
The device is like a pacemaker, except it sends an electrical current straight into the spine, and when the electrodes are properly placed, they can significantly reduce pain.
"We apply an electrical current to alter a person's perception of pain," said Dr. Jill Osborn, an interventional anesthesiologist at St. Paul's Hospital.
Osborn's clinic had 48 patients in for spinal cord stimulation surgery last year — some were new patients, others already had the devices implanted. She said they get 12 of the devices covered by the B.C. Medical Services Plan (MSP) each year, and others are covered by the Workers Compensation Board or programs for other specific pain patients.
Each unit costs between $22,000 and $25,000 including the electrodes.
"It's quite limited in the number of patients we can treat," said Osborn, adding that the wait time for MSP patients is two or three years.
And then there's the issue of distance. Clements has to travel about five hours each way from Vernon for her checkups, and the device needs regular updates and reprogramming. She would like to see local specialists who can program her device.
"It would be nice to have some more funding out there," she said.
There are services on Vancouver Island, but Osborn's clinic sees patients from across the province, and even as far away as Whitehorse and Yellowknife. Fewer than a quarter of her patients are from the hospital's catchment area.
"I think every health authority should have a multidisciplinary [pain centre] with a neurosurgeon and an anesthesiologist to work with the patients," said Osborn.
The treatment certainly won't work for any type of chronic pain, but Osborn said it has been proven effective for many cases of failed back surgery pain, complex regional pain syndrome, neuropathic pain and angina.
And, in the cases where it's successful, it can play a big part in reducing opioids needed to manage pain. Osborn said that's been shown in scientific studies.
"They've demonstrated that you can get up to 67 per cent of patients to reduce or eliminate their opioids completely when they have a successful neurostimulator," she said.
Watch: Rebecca Clements describes her severe pain, and then the changes after the device was implanted
Clements, who used to regularly feel sick when taking as much as 60 mg of morphine a day before the device was implanted, has now managed stop taking the drug, though she's still in the process of weaning herself off other medications.
She estimates the neurostimulator has reduced her pain in most of the affected spots by 60 to 75 per cent.
"My husband and I can dance," she said, adding that she cried the day the soothing device was implanted.
"It gave me my life back."
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