DRG Stimulation Explained: Who It’s For, How It Works, and What to Expect

Chronic nerve pain.

Just reading that phrase might send chills down your spine. Long-term pain can be frustrating, exhausting, and hard to treat. You’ll probably start with some medication. When that doesn’t work, you’ll turn to physical therapy until someone recommends an injection. At your wit’s end, you opt for surgery. Still, somehow, you haven’t found relief. Sure, every now and then you feel like your old self. But lasting relief? Still evasive.

A treatment gaining steam in the field recently is called dorsal root ganglion stimulation, commonly known as DRG. It’s an advanced, targeted treatment that works on specific nerves, intercepting the pain signals on their way to the brain. It’s often credited with achieving long-term success after other treatments fail.

But how does DRG stimulation work?

And is it for you?

We’ll help you find answers – once and for all.

What is Dorsal Root Ganglion Stimulation

Dorsal root ganglion stimulation is a therapy that involves implanting a medical device in your body near the spinal cord. When physical therapy, medication, and surgery fail to achieve the desired result, DRG can be quite effective. By setting up shop near the sensory nerve center, the implant provides focused stimulation that redirects pain signals from a specific region of the body on their way to the brain.

What types of pain can DRG treat?

Persistent post-surgery pain If you’ve had an operation but the pain hasn’t dissipated – often known as failed back surgery syndrome – DRG can provide localized relief. Since DRG pinpoints the specific nerves associated with the painful area, the treatment can quiet ongoing leg pain and residual nerve pain that follow a procedure.

Complex Regional Pain Syndrome CRPS is a continuing severe, often burning pain in a specific area that exceeds the distress of the initial injury. Since DRG is a targeted pain-relief delivery system that alters pain signals before they reach the brain, it has become an important option for patients with conditions like CRPS.

Foot, Ankle, Knee, or Groin Pain Dorsal root ganglion stimulation’s effectiveness is centered around precision. So when you have a targeted injury – whether a result of muscle strain, overuse, infection, or a failed surgery –DRG can mute pain in a way other treatments can’t.

When all else fails Because of the intrusive nature of dorsal root ganglion stimulation – it requires internal implantation of a medical device – it’s often used as a last resort for chronic nerve pain. Be that as it may, it’s proved effective in countless cases where medication, physical therapy, injections, and even surgery had failed.

How to know if you’re a candidate for Dorsal Root Ganglion Stimulation

There are a few telltale signs that you’re a strong match for dorsal root ganglion stimulation. We consider DRG a last-resort option for severe localized pain. That means you must be suffering from chronic pain lasting at least six months. Anything less than that and you should try less intrusive treatments.

Your pain has to be targeted in a specific area. (If it’s not you might be a better candidate for spinal cord stimulation.)

You should have already tried more conservative treatments. Have you undergone physical therapy? Have you been prescribed medication? Have you had injections aimed at relieving your pain? Have you had a surgery that hasn’t had a strong enough impact?

If you feel that you qualify based on these conditions, contact your doctor.

The DRG patient journey

Given the fact that dorsal root ganglion stimulation is a last-resort option – and given its effectiveness – it should not surprise you that it’s a somewhat comprehensive process. There are six steps every patient carefully follows along the journey. Here’s what that looks like.

1) Evaluation

We don’t jump right from pain to DRG. Actually, we need to see that you meet certain parameters before we go any further. Because DRG is one of several advanced treatments we consider for chronic pain, so not everyone with a long-term issue will match this specific criteria.

When you visit Dr. Dang at Hudson Pain and Spine, he will ensure you’re a true fit for dorsal root ganglion. He will ask some of the following questions: Is the pain nerve-related? Is the pain localized? Have we tried conservative treatments, and which ones? Can we make a clear diagnosis? Is another treatment more appropriate?

2) Trial

Many patients don’t realize there’s a trial period involved in DRG, but it’s a crucial step. We don’t simply implant a permanent medical device in a human body without ensuring it works.

Typically, we place a temporary, wearable device on the outside of the body where thin wires track internally from near your target nerve to the battery, worn on a belt or harness. The patient can use it for five to seven days at home, resume most daily activities, and monitor the pain.

The fact you can experience the therapy before committing to it is one of DRG’s greatest benefits.

3) Success

How do we evaluate success following the dorsal root ganglion stimulation trial period? “I feel a bit better” isn’t going to cut it. A structured evaluation centers on questions such as: Did pain decrease significantly? Did function improve? Are daily activities easier? Was medication use reduced? Did quality of life improve?

If during your trial period you found yourself capable of walking further, sleeping better, and driving comfortably, those are strong indications your trial was successful. If you were able to return to your hobbies, play with your kids, and do some light exercise, you sound like a good fit for dorsal root ganglion stimulation.

4) Implant

If your trial provided meaningful pain relief, your doctor may recommend you move to the next phase: permanent implantation for long-term pain management.

What exactly is going into your body here? The implant includes a battery-powered stimulation device and a series of thin insulated wires. The procedure is done under local anesthesia and generally takes a few hours or less.

Following the procedure, many patients report the ability to feel the implant if they put a hand to the area, though most stop noticing it once through the healing period. Not to worry – the device won’t be visible to others!

The treatment works by sending stimulation from the device to your nerves. So… will you feel the stimulation? In the past, many patients have described a tingling sensation (known as paresthesia), but modern advancements have largely eliminated that. The experience varies, but the overwhelming feedback from DRG patients is simply less pain.

5) Recovery

There’s a short recovery period that should ultimately lead to a life free of chronic pain. So what does that look like in the short-term? Typically, patients can go home the same day of the operation. In the days following your procedure, you’re sure to feel some soreness at the point of incision, and you’ll have to keep it dry like any wound.

We recommend that you avoid driving at least until you’ve ceased any painkilling medication. It’s crucial to avoid bending, lifting heavy, and twisting for several weeks. Reaching overhead is especially likely to impact the wound.

Most patients are completely healed by six or eight weeks following the procedure. At that point, you can begin a gradual return to regular routines and activities. You’ll continue to make regular clinic visits to adjust your device’s settings and consult on your readiness for more high-impact activities.

6) Long-term management

With a successful DRG implant, you can mostly forget about it and go back to living a fruitful, pain-free life. But there are still longer-term considerations now that your device is living with you.

You may want to reprogram the device periodically. It’s important to be aware of what you’re feeling as it relates to the stimulation and how that changes over time. Regular follow-up appointments are a good chance to monitor and discuss any significant changes with your doctor.

Frequently Asked Questions: Dorsal Root Ganglion Stimulation

Is DRG stimulation permanent?

Yes. It is permanent in that it is an internal long-term solution that can remain in place indefinitely. However, it is reversible and removable should your condition change or should its effectiveness not be satisfactory.

How successful is DRG stimulation?

For focused, severe pain, dorsal root ganglion stimulation typically delivers meaningful pain relief in 74% to 81% of patients – meaning pain reduced by 50% or more.

Does DRG stimulation hurt?

No. The stimulation reduces or eliminates pain, or in some cases replaces pain with a tingling sensation. The surgical procedure is done under local anesthesia and therefore should be painless.

How long does the battery last?

Your medical device will typically need to be replaced once every five years. Unlike traditional spinal cord stimulators, the battery does not need to be recharged between replacements.

Can DRG help if previous treatments failed?

Yes. One of the great benefits of dorsal root ganglion stimulation is that it’s hyper-localized, so it targets a specific painful area by intercepting harmful nerve signals. Still, DRG should be treated as a last resort once simpler options have been exhausted.

How Hudson Pain and Spine can help

Folks in the Englewood, New Jersey area with chronic pain should contact Hudson Pain and Spine. Dr. Saurabh Dang, a double board-certified pain management specialist and an expert in DRG treatment. He can help determine if this treatment is right for you.

If your pain lasts more than two weeks, includes radiating pain, numbness, tingling, or weakness, and limits your ability to work, sleep, or do normal activities, contact Hudson Pain and Spine to schedule a consultation.

Hudson Pain and Spine 25 Rockwood Place, Suite 335, Englewood, NJ 07631 Phone: (201) 605-9000