Advances in Back Pain

If you’ve ever moaned in agony from back pain, rest assured—albeit uncomfortably—that you’re not alone. More than four out of five Canadians will suffer from it at some point in their lives.

Back pain can originate from many sources and treatments are just as varied, often only providing temporary relief. But the search for a silver bullet continues. Doctors and scientists are reporting success with the following new and impending treatments that can ease back pain for some sufferers while offering hope to all.

New Neurostimulator

An implantable device called a “neurostimulator,” works by sending mild electrical impulses along the spinal cord. “The exact mechanism of action is not well understood,” says Lynda Pike of Medtronic of Canada, “but the device blocks the pain signal from getting to the brain.” The latest model, the RestoreUltra, can operate for nine years with a battery recharge every four to six weeks.

A surgeon makes a small incision in your back, then delicately feeds a neurostimulator lead with eight electrodes through the incision and into the space just outside the membrane covering the spine. Sedated but still responsive, you would answer the surgeon’s questions to pinpoint where the lead provided the most benefit.

A few days later, the neurostimulator is implanted through a five-centimetre incision in your abdomen. Two weeks after that, the device is activated.

Neurostimulator-implant surgery is available in every province, with the exception of Prince Edward Island and Newfoundland and Labrador.

The Dekompressor

Scientists estimate about 50,000 of the current cases of lower-back pain in Canada are caused by strain or injury to spinal disks. Treatment usually involves physical therapy or epidural steroid injections to reduce inflammation. For serious cases of herniated—or “slipped”—disks, patients typically resort to surgery, despite no guarantee of a cure.

While surgery will still be an option, doctors have been developing less-invasive methods of reducing painful disk pressure on adjacent nerves. One of the most advanced techniques, percutaneous diskectomy, involves removing a small amount of tissue from the disk nucleus through a tiny puncture in the skin. “The theory is that when the hydrostatic pressure inside the disk is removed, the pressure transferred to the nerves compressed by the herniated disk is also reduced,” says Dr. Steven Helper of the False Creek Surgical Centre in Vancouver. “It’s like taking a bit of water out of an overfilled balloon.”

Doctors can now opt for the Stryker Dekompressor, a probe that uses a tiny titanium blade and vacuum action to remove a small amount of disk material. This “decompression” alleviates some pressure on the pinched nerves caused by the herniated disk. The procedure lasts less than an hour, and patients go home with only a small bandage over the insertion site; they then wear a lumbar brace for a couple of weeks. Helper says that some 70 percent of patients experience a substantial reduction in pain.

The Dekompressor is available to surgeons across Canada—including Dr. Richard Dumais in Moncton, N.B., the first in the country to use the device.