Surgical methods

Surgical methods are sometimes used to remove pain. They are considered one of the most effective methods of fighting cancer. They can focus on the removal of the immediate cause of pain – eg in the case of removal of gallstones in gallstones or drainage in the case of chronic pancreatitis. Researchers are working on constantly improving the methods of surgery, so as to minimize the risk of life and health, and save them as much as possible. In order to determine the most effective method of treatment of your ailments, you must consult a doctor who is a specialist in your disease.

Neuro-surgical methods

One of the types of surgical methods are the neurosurgical methods of combating pain. They are usually used in situations when other methods of treatment fail. Their goal is to directly reduce or remove pain in the patient. Doctors use them relatively rarely due to invasiveness – sometimes the pain is so strong that their use is necessary. Some of the neurosurgical methods used to treat pain will be described in the following article.

Stimulation of peripheral nerves

This procedure consists in inserting the electrodes directly above the nerve into the subcutaneous tissue. Thanks to the implantation of the electrode, the “gates of pain” and axonal conduction are blocked (axons are the nerve fibers responsible for transmitting information). This method has a certain advantage over non-invasive methods of stimulation (e.g., placing electrodes on the skin). Nowadays, it is also possible to better match stimulation to the individual needs of the patient. On the other hand, however, this method has many limitations: there is a risk of complications, such as uncontrolled displacement of the electrode, causing excessive pressure on the nerve and the possibility of infection. In addition, peripheral nerve stimulation is an expensive method.

Electrode implantation is performed in hospitals and neurosurgical wards. Diseases in which this method is used should qualify as characterized by strong, uninterrupted pain, which, however, can be partially alleviated by the use of non-invasive methods. Belong to them:

  • some phantom pains (pain in the place of the limbs, which the patient lost as a result of amputation),
  • migraines that are not susceptible to other treatments and are accompanied by nausea and photosensitivity,
  • severe pain resulting from traumatic damage to the peripheral nerves,
  • spinal cord secrecy,
  • others whose treatment is not possible by non-invasive methods.

Spinal cord stimulation

Spinal cord stimulation is a neuromodulation method that involves stimulating spinal cord structures by placing the electrodes at the height of the painful site. The mechanism of its operation is not fully understood, however, it is known that some patients are relieved of pain. The indication for the use of this kind of stimulation are, among others:

Phantom pain

  • post-traumatic neuropathies (pains caused by nerve damage),
  • post-operative pain emerging after the spinal failure.

The undesirable consequences of the procedure include the possibility of infection, dislocation or dysfunction of the electrode and the so-called hyperalgesia (hyperesthesia) – excessive pain sensation.

Deep brain stimulation

It is a method that involves placing electrodes directly in the brain structure that doctors want to interact with. For some patients it helps to control pain attacks. The application is, among others, in:

  • cluster headaches – very severe headaches that occur at various intervals (eg several times a year) and last several to a dozen or so weeks, during which the patient suffers from painful attacks with varying frequency,
  • сhronic paroxysmal hemicrania – a very rare disease in which headache attacks can occur up to several dozen times a day.

The undesirable side effects of this treatment include possibility of infection, double vision or fainting.

Chordotomy

Chordotomy is an invasive method used for very severe pain, e.g. cancer. It involves the destruction of selected spinal cord nerves through their incision or incision. This results in blocking the sensation of pain, but also inability to feel the temperature.

Persistent pains are also possible due to the nerve blocking method by injecting an anesthetic into the area.