Nerve-Stimulating Device Delivers Long-Awaited Solution for Patient’s Chronic Pain
James Brown waited four years to find relief from debilitating knee pain that stumped doctors.
After an injury while serving in the Army, Brown, 28, visited several health care providers seeking a solution before Shannon Clark, MD, neurosurgeon with Sentara Neurosurgery Specialists, suggested a promising new technology to control pain.
Brown was a candidate for a new implanted device (approved by FDA in 2016) that stimulates dorsal root ganglion near the spinal nerve roots. The successful surgery ended years of misery and frustration.
"I can walk without a cane and without my knee giving out," said Brown, of Norfolk. "Before I couldn't stand up past 20 minutes. Now I can dance. I can move around. I can run."
Brown's injury occurred in December 2014 during basic training in South Carolina. He was participating in group physical training on a concrete surface when he slipped off the edge and slammed his knee into the ground.
"It didn't bother me at first because my adrenaline was up," said Brown, who was a patriot missile systems maintainer. "But as time went on I noticed that I ran slower and had more pain in my legs."
The pain eventually got so bad, he had to be medically discharged from the Army in February 2018.
"It got to the point where I couldn't do anything," said Brown, who is married with three young children. "I could barely sleep at night. I couldn't play with my kids. I felt like less of a person every day I woke up."
Imaging tests over the years didn't reveal any structural damage to his knee. A pain specialist in Texas diagnosed Brown with complex regional pain syndrome, a chronic pain condition that usually affects one limb (arm, leg, hand, or foot) after an injury. Experts believe it's caused by damage to the peripheral and central nervous systems.
For 1 1/2 years, Brown had to rely on medication to mitigate his pain. He couldn't drive, had difficulty working and was desperate for a solution.
Tiny Device Provides Great Relief
After his discharge from the Army, Brown moved back to his hometown of Norfolk. Veterans Affairs referred him to Sentara Neurosurgery Specialists and Dr. Clark for "DRG" therapy.
The implantable device treats chronic pain of the lower limbs and helps patients with complex regional pain syndrome.
DRG therapy works by stimulating the dorsal root ganglia (DRG), structures along the spinal column made up of densely populated nerves cells. The DRG regulates signals and sensations that travel through nerve fibers along the spinal column to the brain. It blocks sensation of pain from being transmitted to the brain. Because the small lead fibers can be inserted in neuroforamen (where the nerves come out in spine), it can accurately target the specific part of the body where the patient feels pain.
Brown met with Dr. Clark in November 2018. The first step was a type of trial run.
Dr. Clark placed a temporary device to see if it would provide relief. During this phase, leads are placed through a small incision in the back. The leads deliver electrical impulses from the generator, taped to a patient's back, to the DRG. Patients use an app on their phones to control the level of the impulses delivered.
After a week, Brown was confident this new technology was an answer to prayers. During a second surgery in December 2018, Dr. Clark implanted the permanent device, which consists of two thin wire leads in the spinal canal, which were already placed and a small battery that measures 2 inches by 2 inches.
DRG technology has lifted the dark cloud that's followed Brown over the last few years with debilitating, chronic pain.
After the surgery, Brown went to physical therapy for a month to help him get moving again. Now he can play with his kids, work again and hopes to resume taekwondo. He's employed at Family Dollar but would like to pursue a career in cybersecurity.
Brown credits his wife, Maresha, for her support throughout his ordeal. He's also extremely grateful to Sentara and Dr. Clark for using her expertise to help him.
"She is the best in her field," said Brown. "She explained everything thoroughly and took every precaution. This changed my life."