I remember in 2009, a patient came into the office and asked that her spinal cord stimulator be removed. It had been implanted due to severe unremitting back and leg pain.
Ok, let’s explain that part. Back pain is very common and some people ultimately need treatment for it. A certain number of require back surgery. Out of the those that do receive back surgery a certain percentage still receive no improvement in their symptoms. Those patients sometimes return for a second back surgery or they can receive a spinal cord stimulator. A spinal cord stimulator is a device that is inserted into the spine and powered by a battery pack under the skin usually in the back. The device sends electric signals into the spinal cord that can help the patient decrease their experience of pain. It also comes with an external remote control that the patient can use to change the frequency and pattern of the electrical signals for days they have more or less pain. They can even turn it completely off if they are not having pain.
I expressed to her that we could absolutely do so however I was wondering why she wanted it removed. She had only had the device in for two years. She stated that her back had diminished to the point that she had not used the device at all in over a year.
Structurally, her back looked the same as it did a year ago so that did not explain her situation. It was unlikely that her biological milieu had changed to such a degree in a year without intervention for her severe back pain to diminish by that much.
So, I asked her what was different in her life over the last year. She stated that not much had changed. I pressed her for further data. Did she change her diet, change supplements, try a different cereal, anything….I was looking for a clue.