Locations:
Search IconSearch

If You Suffer from CRPS Pain, DRG Stimulation May Provide the Relief You Crave

In a major study, 93% of people saw a reprieve in pain

Illustration of nerve cells being electrically stimulated

Chronic regional pain syndrome (CRPS) takes a toll: Your nerve cells become hypersensitized to the point where everyday stimulation — like a draft of air or touch — causes an out-of-whack pain response.

Advertisement

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

“Our bodies use acute pain as a warning system,” says pain management doctor Nagy Mekhail, MD, PhD. “If you sprain your ankle, the pain prevents you from putting your foot down and causing further injury. If you have chest pain while walking up two flights of stairs, it sounds an alarm to seek medical advice.”

But with chronic pain conditions like CRPS, pain loses its protective function and becomes a disease by itself. Thankfully, new treatments are being developed every day — like ketamine infusions and dorsal root ganglion stimulation (DRGS). Dr. Mekhail discusses DRGS, including who is most likely to benefit:

Q: What is the dorsal root ganglion?

A: Each segment of your spinal cord manages sensations for a specific area of the body. It’s like train lines heading out for different parts of the city. And the dorsal root ganglion (DRG) is the transportation hub: Every stimulus flows through the DRG, the nerve center of the spinal cord, on the way to the brain where it gets processed.

But the DRG is not just a sensation-relay station: It can filter pain stimuli to make them more or less intense.

Q: How does a DRG stimulator relieve pain?

A: The goal of DRGS is to make the nerve cells less sensitive. We use electric stimulation over the dorsal root ganglion to create an electric field, which slows the pain signals traveling from the limbs to the spinal cord then onto the brain. The electric field reprograms the nerve cells to decrease the super sensitivity that goes along with CRPS. This process normalizes the patient’s pain sensations.

Q: How do you implant the DRG stimulator?

A: The procedure takes 60-90 minutes. The team will:

  1. Give you light sedation.
  2. Numb the skin.
  3. Make a small incision beneath the skin in the buttocks or abdomen.
  4. Place a pulse generator — similar to a pacemaker — in the incision.
  5. Make tiny incisions to place four leads (wires) directly over the DRG associated with the pain-causing extremity.

When you move your foot or hand, the leads send minor electrical impulses to the DRG to block the pain signals from reaching the brain.

Q: Can you back up a beat and tell us why CRPS causes pain in the first place?

A: It seems with CRPS there is a structural change in the DRG cells. The result is pain that no longer needs a stimulus to start. The pain is constant for no rhyme or reason.

Q: How effective is DRG stimulation for CRPS treatment?

A: The initial study compared DRGS to spinal cord stimulation (also called SCS, which is similar, but doesn’t target the dorsal root ganglion). The results were impressive:

  • 70 to 80% of them had 80% pain relief. (Only 52% of the SCS group had that level of pain relief.)
  • Almost 93% of people who received DRGS had at least 50% pain relief.

Q: Who is eligible for this CRPS-pain destroyer?

A: DRGS is an invasive procedure — we implant an electrical stimulator into the body — so we prefer to try less invasive methods first, such as:

  • Medications.
  • Nerve blocks (a localized injection of steroids and pain relievers).
  • Physical therapy.

Advertisement

If the pain is chronic and uncontrollable with other treatments, it’s worthwhile to consider DRGS because it works so well.

Q: What’s the catch? Are there risks we need to be aware of?

A: The risks are the same as with any procedure: a chance of bleeding or infection at the surgical site. But those are rare occurrences. There’s also a small chance that the wire that generates the electrical field will move and need to be repositioned.

The only other consideration is that the stimulator runs off a battery that gets implanted into the buttocks. The battery lasts five or six years, but eventually, it will need to be replaced. Fortunately, it’s a pretty quick procedure (15 to 20 minutes).

Q: Could DRGS work for someone that has chronic pain that isn’t CRPS?

A: In my practice, I’ve seen DRG stimulation help with other types of pain, including:

  • Osteoarthritis.
  • Post-amputation pain.
  • Neuropathies (nerve conditions) from peripheral vascular disease or diabetes.
  • Any pain localized to a specific part of the body.

Advertisement

Learn more about our editorial process.

Related Articles

Red-headed patient in dental chair in dentist office with healthcare provider
April 9, 2024/Chronic Pain
Why Redheads May Need More Anesthesia

If you have naturally red hair, feeling the pain may be in your DNA

physical therapist working with patient on their back
March 4, 2024/Chronic Pain
12 Ways To Treat Your Back Pain Without Surgery

From physical and biofeedback therapy to nerve ablations and blocks, there are many nonsurgical options for managing back pain

Close up of hand in blue gloves inserting dry needling into muscles
February 13, 2024/Chronic Pain
What’s the Difference Between Dry Needling and Acupuncture?

Both can help reduce pain, but they’re very different in terms of origins, philosophies and practices

Close up of gloved hands holding hot drink, steaming mug, outside in the cold
January 17, 2024/Chronic Pain
10 Cold Weather Tips for Managing Raynaud’s During Winter

Use foot warmers and hand warmers, layer your clothing and avoid sharp shifts in temperature

Close up of dry needling
December 13, 2023/Chronic Pain
Dry Needling: What It Is and How It Works

As part of a larger treatment strategy, it can help decrease muscle tightness and reduce pain

person holding lower back at computer
September 19, 2023/Chronic Pain
Back Pain, Your Spine and Father Time: 13 Ways To Treat Age-Related Back Pain

Rest, physical therapy, acupuncture and nerve blocks are just a few ways to find relief

person doing yoga in living room
August 8, 2023/Chronic Pain
Find Relief From Back Pain With These Home Remedies

Get moving, use cold packs, and try yoga and stretches to ease back pain

Trending Topics

Female and friend jogging outside
How To Increase Your Metabolism for Weight Loss

Focus on your body’s metabolic set point by eating healthy foods, making exercise a part of your routine and reducing stress

stovetop with stainless steel cookware and glassware
5 Ways Forever Chemicals (PFAS) May Affect Your Health

PFAS chemicals may make life easier — but they aren’t always so easy on the human body

jar of rice water and brush, with rice scattered around table
Could Rice Water Be the Secret To Healthier Hair?

While there’s little risk in trying this hair care treatment, there isn’t much science to back up the claims

Ad