Neurological Associates

Pain Management Center

Vero Beach, Florida

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RSD PUZZLE #74
SPINAL CORD STIMULATOR (SCS)                                                                                                                                                               Please see RSD Puzzles 23 and 106 also regarding SCS

Dear Dr. S.,

Many thanks for your letter of 10/7/96. It was very interesting that you had quite a similar experience regarding the spinal cord stimulator treatment for CRPS (RSD).

I have seen 36 patients so far suffering from RSD who have received spinal stimulator for management of the pain. Of the 36 patients, the pain relief lasted an average of six weeks. Relief was as short lasting as a few hours and as long as over four months. Eventually the pain recurred with more severity.

More importantly, the foreign body of the stimulator in a patient who already had disturbance of plasticity due to long standing RSD, resulted in two phenomena:

1. Spread of RSD to the opposite extremity, as well as development of headache, neck pain and dizziness.

2. Reactive spinal cord ischemia resulting in transient paraparesis and incontinence in two cases, and the development of myoclonic type of jerks in the lower extremities in four other cases.

It is about time to differentiate the neuropathic pain of RSD from the somatic pain of failed neck or failed back syndrome.

In the same follow-up study of the patients, we have noted the effective response in control of the somatic type of pain in 32 failed neck and failed back patients with an average duration of relief being 18 months. No such complications of spread of the disease is noted in somatic (non-CRPS) patients.

In regard to your patient, I am glad she is being treated by you, and if I can be of any help, I will be at your service. Even though we have had excellent results (over 70% success) in 96 RSD patients treated with infusion pump, we always like to save the infusion pump treatment as a last resort because of problems of potential of infection (due to the disturbance of immune system secondary to RSD), and the patients intolerant of even the smallest doses of narcotics in the spinal fluid (noted in 11 patients).

H. Hooshmand, MD

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Copyright © 1997-2006 H. Hooshmand, M.D. No part of this publication may be reproduced, transmitted, stored in a retrieval system other than this specific media, transcribed, or translated into any language without the expressed written permission from the author; H. Hooshmand, M.D. and Eric Phillips and CMNE. This material is for informational and education purposes. It is not meant to take the place of your physician. Before starting, changing, or stopping any treatments or medicines consult your physician.

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The material on the Neurological Associates Pain Management Center Homepage and all it's associated, linked or reference pages is for informational and education purposes. It is not meant to take the place of your physician. Before starting, changing, or stopping any treatments or medicines consult your physician. H. Hooshmand, M.D., Neurological Associates Pain Management Center and Associates will not be held liable for any damage or loss as a result of information provided on this page or associated documentation. Again, this WEB SITE is simply published as an information source and should not be used to treat or make judgments on RSD/CRPS. All associated material on this web site may not be copied, reproduced or quoted without expressed written permission from the owner; Copyright © 1999-2006 H. Hooshmand, M.D.

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This page was last updated on 3/11/2000.