PainCare - Pain Management in New Hampshire

If your condition does not respond permanently or long term to initial more conservative treatments, PainCare offers several implantable technologies for the continual management of pain.

Occipital neuromodulation

Occipital neuromodulation uses the same technology as spinal cord stimulation, which has been around for forty years.  Read more about occipital neuromodulation.

Peripheral neuromodulation (aka peripheral nerve stimulation or PNS)

The peripheral nerves carry information from the spinal cord to all parts of the body. A peripheral nerve stimulator is a device that delivers electronic impulses directly to peripheral nerve fibers along your area of chronic pain. The stimulation of these fibers interferes with the transmission of pain signals from the area of pain to the brain, and tricks the brain into turning off pain perception.

This procedure is done in two separate stages: a trial and a permanent stage. During the trial, leads (very thin cables with metal electrodes on one end and electrical connectors on the other) are placed through a hollow needle near the nerve to be stimulated. The connector end extends out through the skin and is attached to an external battery receiver source that is controlled by the patient. This temporary trial lead is left in place for a week or so to determine if stimulation is effective. If there is significant relief, the next step is a permanent system. The permanent system is implanted under the skin in a surgical subcutaneous pocket, usually located in the abdominal or buttocks fat, just below the skin surface. The implanted battery works much like a pacemaker.

Most peripheral nerve stimulation procedures are performed on an outpatient basis with a local anesthetic and I.V. conscious sedation. Patient comfort and relaxation during our procedures is paramount. Conscious sedation is offered at PainCare to allay anxiety associated with injections and implants. Significant postoperative pain and complications are extremely rare.

The following conditions may be treated with peripheral nerve stimulation:

• chronic recurrent headaches
• migraines
• whiplash and other chronic neck pain
• low back pain
• neuropathies
• complex regional pain syndrome
• post amputation pain

Spinal neuromodulation (aka spinal cord stimulation or SCS)

Spinal cord stimulation is identical to the procedure for PNS described above, except that it delivers electronic impulses directly to spinal cord not peripheral nerves. The permanent implant is a bit more complicated than with peripheral neuromodulation, and attendant risk of complication is somewhat greater.

Spinal catheters

A spinal catheter (intrathecal/epidural) is a method for administering pain relieving medication by a very thin caliber flexible tube placed near the spine. Read more about spinal catheters.