Dorsal Root Ganglion (DRG) Stimulation

Dorsal Root Ganglion (DRG) stimulation is an advanced, FDA-approved pain management therapy that uses mild electric pulses to stimulate the DRG. The dorsal root ganglion is a cluster of neurons (a ganglion) near the dorsal root of a spinal nerve, which is where the nerves begin to branch off from the spine. The DRG is associated with sensory stimuli (including pain) that originates in more distant parts of the body, such as the feet, legs, or arms.

DRG stimulation targets “hard-to-reach” nerves that cause peripheral nerve pain, and can be utilized for some of the most challenging cases of complex regional pain syndrome (CRPS), a condition that creates severe pain and hypersensitivity, primarily in the arms and legs. Traditional spinal cord stimulators have shown limited success in dealing with CRPS, but DRG stimulators are more promising as they are much more specific for the affected body parts.  The implant is a battery that emits mild electric pulses which travel along specially placed leads to “stimulate” specific nerves. This stimulation inhibits pain signals before they reach the brain, providing relief.

Who is a candidate for DRG Stimulation?

You may be a good candidate for a DRG stimulator if any of the following applies to you:

• You are experiencing chronic pain in the feet, arms, legs, or groin
• Unsuccessful results from previous pain treatments and therapies
• Complex regional pain (CRPS) diagnosis
• Phantom limb pain
• Pain after failed joint replacement surgery or other surgeries that increased pain

First Steps

First step is consulting with our pain physicians The first step in any pain intervention is discussing your history, and previous treatments and therapies. If the conclusion is made that DRG could be right for you, the first step is participating in a trial DRG to gauge the impact the implant will have on reducing your pain.

What can I expect during the trial?

One of the benefits of the DRG neurostimulation system is that you can be fitted with a temporary device that works like an implanted system but can be removed. This allows you to determine its effectiveness for your pain prior to undergoing an implant. You will have a short, minimally-invasive outpatient procedure, during which you are awake and answering questions. Your doctor will:

• Implant a few small, thin leads near your DRG.
• Attach the leads to a temporary generator that you can wear outside of your clothing or on your belt.
• Ask you to provide feedback on where you feel stimulation.

The procedure takes around 30-40 minutes to complete. Afterward, you will be trained to use the device and find the settings that feel best. While you wear the temporary system you will be asked to limit physical activities that involve lifting, bending, twisting or raising your arms above your head. Otherwise, you will be able to resume daily living.

At the conclusion of the trial period, you will return to the clinic to have the leads removed and discuss the amount of pain relief you received during the trial. If you feel the implant worked well enough to pursue a permanent implanted system, we will then submit an authorization request to your insurance company.

What can I expect during the implant surgery?

Prior to the implant surgery you will need to have preoperative testing and a DRG device education appointment, where we discuss operation, maintenance, expectations, and also risks and potential side effects. It’s important that you discuss with your doctor all of the complications associated with an implanted neurostimulation device and whether you are at risk.

For your safety, you will be required to have a driver take you home after the implant surgery. The implant does involve a minimally-invasive surgical procedure that includes implanting the generator under your skin.

As with the evaluation procedure, you will be awake and answering questions. Within a few days, your system should begin working just like before.

What can I expect after the surgery?

You will be brought to the recovery area and monitored by a nurse until your anesthesia wears off, and antibiotics will be prescribed to prevent infection.

To prevent movement of the implanted leads, there are certain activities you should avoid for six to eight weeks after the surgery, including bending at the waist, twisting, reaching overhead, and lifting more than five pounds.

Seven to ten days after the surgery, you will come in for a post-operative examination, to examine the incision and also meet with a representative from the DRG device company who will turn on the device and program it. That is it, except to enjoy your new pain relief.

DRG Stimulation at Precision Pain Care

Our Precision Pain Care physicians are members of an exclusive group of pain doctors that are specifically trained and certified to perform DRG stimulation procedures. We offer this procedure in conjuncture with our mission of providing quality, compassionate and precise care for our patients suffering from chronic pain.

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