The Role for Spinal Cord Stimulation in chronic pain…

SCS implanted deviceSpinal Cord Stimulation (SCS) is a very scary term for a quite simple, and usually very safe, treatment to control some types of chronic pain.  The concept is that by applying a low intensity electrical signal to certain parts of the spinal cord, via a tiny wire outside the cord sheath (i.e. not touching the cord), certain types of pain in certain locations of the body can be mitigated.

The types of pain that seem to respond the best are limb pain, especially lower extremity, due to nerve injury, and back pain or so called axial pain.  A spinal cord stimulator should be trialed, percutaneously, for at least 4-5 days if not longer.  Trialing of shorter duration is likely to encourage placebo effect and the patient may well end up with a permanent implant that is not useful beyond a few months.

It is estimated that 50% of solidly trialed patients who received a well placed perm SCS are satisfied after one year, 40% after three years.  These numbers compare favorably with conventional surgery outcomes.  As with any surgical technique, SCS carries the usual possible complications including infection, displacement of the electrodes, cord damage (very unusual) and sometimes a need to remove the system entirely.

SCS is often tried after conventional spine surgery is performed and has failed (laminectomies, discectomies, fusions, etc).  It is thought that trialing before these often ineffective surgeries is a better approach, since failure to improve with conventional surgery makes SCS trials more difficult and less due to adhesions.  Despite these considerations, SCS has considerable virtue in that it does not involve medication, which for chronic pain can be a never-ending battle.

About Dr. Michael J. O'Connell, New Hampshire
Dr. Michael J. O'Connell of Barrington, New Hampshire, has forged a distinguished career spanning over three decades, as entrepreneur, physician, businessman, philanthropist and healthcare consultant. As former owner, administrator and CEO of a 225+ employee multi-specialty medical practice, Dr. O'Connell has dedicated his entire professional life to helping patients with family medicine and especially those experiencing chronic pain and all aspects of addiction. Since selling his family of healthcare businesses, he has never once contemplated retirement despite his rich and fulfilling journey, but instead has turned his focus to consulting in an industry starved for courage and creativity. Having weathered many political, technological and legal challenges, there is hardly a storm he has not confronted, a tempest he has not quelled, an urgent need he has not met. While the talking heads and self-proclaimed experts in the field have assumed the conventions and standards of the times, Dr. O'Connell does not believe in merely reflecting the herd mentality, but rather in leading the charge. Eschewing political correctness, Dr. O'Connell says and does what needs saying and doing, and not what the mindless masses expect. In addition to the continual education afforded by his variegated life experiences, Dr O'Connell earned his BS in Biochemistry at the University of NH in 1975, his Medical Degree from Dartmouth College in 1981, interned at Walter Reed Medical Center in 1982, Residency/Fellowship at UCSF in1986, and finished his Masters in Healthcare Administration at UNH in 1995. Dr. O’Connell enjoys many outdoor activities, including rock climbing, snowboarding, hiking, and golf. Through the decades Dr. O'Connell has supported many non-profit charities to include the St. Charles Home in Rochester NH, the Tri City VNA and Hospice, Hyder House, and Cocheco Valley Humane Society. To the latter organization alone Dr. O'Connell has donated over $180,000 and pledged another $250,000 in the “Bring-Us-Home” campaign for a new building. His “Matching Donations Christmas drive” has generated over $175,000 in charitable giving from the community. In addition Dr. O'Connell has participated in many dozens of other volunteer and donation efforts locally as well as in Africa and the Dominican Republic. For a listing of how I gave back to the community during my career and continue to do see:

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