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When Nerve Pain Just Won’t Stop, Neuromodulation Can Help

A whack to the elbow hurts, but doesn't require neuromodulation


Ever whack your funny bone?

Then you probably know that “funny bone” is a terrible name—whacking that spot on your elbow is not funny at all. But it isn’t just bone, either. The not-funny sensation associated with the so-called funny bone comes from a nerve.

Luckily, the funny bone (or “unfunny nerve”) pain usually goes away pretty quickly.

But people with intractable pain have pain that does not respond to medical treatment or get better with time. Intractable pain can occur anywhere in the body. It can produce physical misery as well as frustration, depression, and social isolation.

At the Pain Center at Columbia’s Department of Neurosurgery, Dr. Christopher Winfree offers hope to some patients with intractable pain. He sees patients who have been unable to get enough relief from their pain despite working with their primary care physicians, neurologists and pain management physicians.

Dr. Winfree specializes in pain neurosurgery for these extreme cases. He treats the spine and the peripheral nerves. (Peripheral nerves are nerves that carry information between the spine and the extremities–like that unfunny nerve in the elbow.)

One technique he uses is called neuromodulation. For this technique, he implants a device that can deliver a weak electrical current or a small dose of medication to a nerve. The neuromodulation device is small, like a pacemaker, and has a remote control that the patient can control.

Electrical stimulation from the device works on a similar principle as rubbing your elbow or your shin after you whack it. The mild sensory input can help “drown out” pain signals as these sensations travel along the nerve fibers. To read more about how this works, and find out about one application of this technique, see our post Turn Up the Static When Back Pain Won’t Stop Calling.

Dr. Winfree attends AANS/CNS Joint Section on Pain Executive Council Meeting
Dr. Winfree attends AANS/CNS Joint Section on Pain Executive Council Meeting

As a pain neurosurgeon, Dr. Winfree has developed a deep knowledge of neuromodulation and its applications. He feels it is crucial to share his knowledge with other neurosurgeons so that they may better help patients with intractable pain.

Most recently, Dr. Winfree spoke to his peers about neuromodulation at the 2015 meeting of the American Association of Neurological Surgeons. At AANS 2015, Dr. Winfree spoke at a seminar geared for general neurosurgeons (i.e., not pain specialists).

The course faculty taught attendees how to compare noninvasive and invasive therapies for pain treatment; how to weigh the pros and cons of weak electrical stimulation or drug delivery; and what outcomes to expect from these therapies. The course was focused on practical ways that the general neurosurgeon can help patients with intractable pain.

At this same meeting, Dr. Winfree also met with the AANS/CNS Section on Pain. This group brings together neurosurgical pain specialists from the AANS and another neurosurgical group, the Congress of Neurological Surgeons. The Section meetings are excellent times for these specialists to talk with each other about the intricacies of their work. Dr. Winfree has long been active in the AANS/CNS Section on Pain—back in 2013, he wrapped up a two-year term as the Section’s president.

Dr. Winfree (R) and mentor Dr. Kim J. Murchiel (L) at AANS 2015
Dr. Winfree (R) and mentor Dr. Kim J. Burchiel (L) at AANS 2015

On the last day of AANS 2015, Dr. Winfree delivered a general lecture that focused on neuromodulation for peripheral nerve pain management.

The next time you find yourself rubbing your elbow after a whack to the unfunny nerve, take a moment to be grateful that the pain is fleeting… and that experts like Dr. Winfree may be able to help with neuromodulation when it isn’t.

Learn more about Dr. Winfree on his bio page here.

patient journey

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