Recently, in the wake of a growing numbers, much attention has been focused on reducing prescription drug opiate abuse. Opiate overdose deaths in the U.S. grew to 29,000 in 2014, an increase of 137 percent since 2000.

While the government is taking steps to address the problem that now claims more U.S. lives than traffic accidents, many primary care physicians might not know they can refer some chronic pain patients for spinal cord stimulation neurosurgery that can be successful reducing chronic pain without long-term use of addictive opiate painkillers.

Spinal cord stimulation involves surgically implanting small electrodes connected to a pulse generator over specific regions of the spinal cord. The electrodes for this technology, similar to a cardiac pacemaker, produce electrical impulses that affect transmission of pain signals.

Erika Petersen, MD, associate professor in the University of Arkansas for Medical Sciences (UAMS) College of Medicine’s Department of Neurosurgery, does this type of surgery for about 100 patients per year.

“The majority of healthcare practitioners in Arkansas have limited experience with these devices, and may not know which patients would be good candidates for one, or how to connect a patient to a practitioner who is able to evaluate a patient for this procedure,” Petersen said. “I see patients who have been treated for a chronic pain for a decade or more who tell me, ‘No one has ever talked to me about a stimulator.’ Or they had a physician say, ‘They don’t work. You don’t want one.’ There is a lack of awareness and some misinformation about spinal cord stimulators in the medical community.”

Most people trust what their doctor recommends in terms of technology. Petersen said the advances in technology over the past two years mean that many clinicians may not realize that today spinal cord stimulators are a proven technology that can provide durable pain relief to people with refractory pain.

“Physicians like me are trying to get the word out to educators and providers about the advantages of this technology to promote better patient access to the whole spectrum of treatment options,” Petersen said. “A lot of people don’t recognize there are technologies like a spinal cord stimulator that can effectively address chronic pain for patients who think they have no other option besides use of painkillers. Especially with Centers for Disease Control and Prevention (CDC) putting out new guidelines that recommend minimizing use of narcotics for chronic pain, the goal is avoiding opioids. One way this can be done is to use electrical stimulation, instead of narcotics, to change the pain signals. In a lot of instances, this surgery is covered by insurance and Medicaid.”

Spinal cord stimulators can be considered for long-term, chronic back pain including pain that gets worse even after surgery to correct it, nerve pain or numbness in the arms or legs, complex regional pain syndrome, and other neuropathic pain syndromes.

There has also been a recent major improvement in the devices now being MRI-friendly, allowing patients to have more freedom of choice for diagnostic procedures.

“Studies show that 82 percent of patients implanted with a spinal cord stimulator are expected to need an MRI within five years of receiving their implant, and this device offers patients the confidence of knowing that they can receive optimal diagnostic imaging anywhere in the body should the need arise,” Petersen said. “This is a huge deal because of concerns over excessive X-ray exposure. So if you have the ability to get an MRI, it may be a safer diagnostic test. The other advantage is that MRI shows tissues in a different way. For example, if I look at a CT scan, I can see the outline of the spinal cord, but I may not be able to see subtle swelling that might suggest cancer or injury. MRI shows the spinal cord tissue much better. Access to MRI without any restrictions is a huge impact for patients. This is the first SCS paddle electrode that has no restrictions on which body part is imaged with MRI as long as it’s done in an appropriate scanner.”

Petersen broke new ground by being the first surgeon in the world to implant two of the first commercially available Medtronic spinal cord stimulator devices.

Petersen said it is very rewarding to see how patients are helped by the surgery.

“Often people are depressed because they can’t work, they can’t play with the grandkids, or even go to the end of the driveway to check their mail,” she said. “If I can have an impact on their function and quality of life, that is immense. People tell me it has made a big difference for them, helping them decrease the amount of medication they take, and being able to function more normally. That is very gratifying.”

To learn more: University for Arkansas Department of Neurosurgery, http://neurosurgery.uams.edu/