Chronic Pain of the Foot and Ankle

    Suffering from chronic pain of the foot and ankle requires a multimodality approach.  One can get chronic pain in the foot and ankle for many reasons such as CRPS otherwise known as complex regional pain syndrome, or after trauma or multiple fractures, and also after surgeries 1 can develop chronic foot and ankle pain.  With our increased knowledge in pain management therapies is imperative that we think beyond just the opioid treatments.  Is well-known that opioid treatments with medications such as Percocet and oxycodone can have addictive properties as well as issues with sleep and also when one becomes dependent on these medications the efficacy wears off.  It is important to realize that there are other treatments besides pharmacological treatments and taking pills.

    Over the last few years, there have been introduced to the market as a method of pain management the concept of implantable nerve stimulators.  These were devices that were originally approved for implantation in the back by the spinal column in order to address the pain at the level of the nerve where is exiting the spinal Column.  The name of this treatment is called peripheral nerve stimulation otherwise known as PNS.  The idea of peripheral nerve stimulation has been around since the 1960s, it was in 2012 that there were a number of devices that were introduced to the market that were just approved for spinal implantation.  Currently, there is available on the market a product by stim wave that can be implanted around the nerves of the foot without the need to implant a battery into the foot.  The way this works is that a very small tiny wire is implanted under the skin next to the nerve that is affected and causing the pain.  The way that you get the pain relief is once the small wire that is implanted under the skin is inserted, it becomes activated by an outside activation source that you as the patient can control.  This electrical signal will block the pain messages that are getting sent to the brain from the nerve.  You may feel a small tingling sensation that over time will block the pain and overtime reduce the pain to the point where you will not need to be dependent on pain medications. This is done as a trial prior to permanent implantation.  The trial is run for a week and if you do well with it then there can be a permanent implantation done at that time.  The way this works on a nerve level is the year is an electrode that delivers rapid electrical pulses to the nerve which is actually controlled by the patient to the level that the patient likes in order to get the results that they are looking for.  This is not a TENS unit it works in a very different way TENS units are applied onto the skin this is applied right against the nerve.  As well it uses a different electrical pulse in order to help relieve the nerve.  The main indication is for treatment of chronic pain.  Types of chronic pain in the foot can be from posttraumatic pain, pain from multiple surgeries, complex regional pain syndrome, and diabetic peripheral neuropathy.  However, it is not just limited to the symptoms but these are the most common symptoms.

    Stimwave’s StimQ Peripheral Nerve Stimulator System (PNS) utilizes the same technology as the Freedom SCS System. A neurostimulator with electrodes and a receiver to utilize wireless RF power is placed near a peripheral nerve in your body, below the head, to treat your chronic pain. Fitting through a needle-sized incision allows for placement with minimally invasive surgery, typically as an outpatient procedure.  Once implanted you CAN go into an MRI machine if needed for something else.

    Stimwave Technologies - Freedom SCS
    Size of Stimwave wire

    Before the device is implanted permanently, there is typically a trial period to determine if the therapy is effective for your chronic pain. PNS is covered by most insurance plans.

    If you are interested in looking for an option that can help you with pain control for chronic foot and ankle pain consider the Stimwave’s StimQ Peripheral Nerve Stimulator System. We offer this treatment at the Advanced Foot and Ankle Center of San Diego. Make an appointment today to help ease your foot and ankle pain.