NEUROMODULATION

What Is Neuromodulation?

Chronic pain affects millions of people every day, disrupting sleep, limiting mobility, and making even simple tasks feel overwhelming. For many, traditional treatments like medications, injections, and surgery either don’t provide enough relief or come with side effects and risks that make them unsustainable long term. That’s where neuromodulation comes in.

At MAPS Centers for Pain Control in Chicagoland, neuromodulation represents a breakthrough in pain medicine — a way to manage pain at its source without relying on drugs or invasive surgeries. Neuromodulation uses small, implantable devices that work by communicating directly with your nervous system. These devices send gentle electrical impulses to targeted nerves, blocking pain signals before they reach the brain.

As Thomas Pontinen, MD, LCP-C co-founder of MAPS, explains:

“Neuromodulation works like pain medication would, but without the drugs. It interrupts the pain signal, so your brain never registers the discomfort — all while avoiding the side effects of long-term medication use.”

Here’s how it works:

• A small device is implanted under the skin.
• It sends mild electrical currents to targeted nerves.
• These signals block pain messages from traveling up the spinal cord to the brain.

The result? Even if pain sources like arthritis, neuropathy, or prior injuries are still present, the brain doesn’t register the same intensity of pain. Patients experience relief without relying on ongoing medications or repeated injections.

Watch Thomas Pontinen, MD, LCP-C explain how neuromodulation works and why it’s changing pain management.

Types of Neuromodulation

Neuromodulation comes in three main forms, each designed to target different pain pathways and conditions:

1. Spinal Cord Stimulation (SCS)
Leads are placed in the epidural space along the spine to treat pain that radiates into the arms, legs, or feet. This method is ideal for widespread nerve pain or pain that follows a nerve path down the limbs.

2. Dorsal Root Ganglion (DRG) Stimulation
The newest refinement of spinal stimulation, DRG Stimulation takes neuromodulation precision to the next level. Electrodes are placed along the spinal nerve root serving the painful region of the body, allowing for highly targeted relief. This technique modulates the dorsal root ganglion — a small cluster of nerve cells located just outside the spinal cord — to quiet pain signals at one of their earliest transmission points.

DRG stimulation is best used when pain is localized to a smaller area such as one or two joints in an extremity (for example, the knee, ankle, hip, or foot). It has proven especially effective for Complex Regional Pain Syndrome (CRPS) and focal nerve pain in the lower body.

At MAPS, Dr. Timothy Lubenow played a pivotal role in bringing this therapy to the U.S.

“I was one of six physicians selected to train in Oxford, England, before DRG stimulation was even FDA-approved,” Dr. Lubenow explains. “We learned the technique directly from its pioneers and helped introduce it nationwide. Today, it’s one of our most effective treatments for patients with focal neuropathic pain.”

Clinical studies show that DRG stimulation often provides 50% or greater pain relief, with many patients achieving 70–80% improvement—outperforming traditional spinal cord stimulation in CRPS cases.

Watch Timothy Lubenow, MD discuss the evolution of DRG Stimulation — from early clinical trials to life-changing results for patients with CRPS.

3. Peripheral Nerve Stimulation (PNS)
 A tiny device, about the size of a fingertip, is placed near a specific peripheral nerve to relieve pain in smaller, well-defined areas such as the shoulder, knee, or base of the skull.

Because neuromodulation is adjustable, minimally invasive, and reversible, it has become one of the fastest-growing and most successful treatment options for chronic pain. At MAPS, we’ve seen it help patients regain independence, restore sleep, and get back to living full, active lives.

Talk to your doctor to determine whether Spinal Cord Stimulation, DRG Stimulation or Peripheral Nerve Stimulation is best for your specific condition.

What Conditions Can Neuromodulation Treat?

Neuromodulation is versatile and effective for many chronic pain conditions that have not improved with other treatments such as injections, physical therapy, or surgery. At MAPS, we commonly use neuromodulation to treat:

• Chronic back and neck pain

• Radiating pain into the arms or legs (sciatica, radiculopathy)

• Peripheral neuropathy, including diabetic neuropathy that causes tingling, burning, or numbness in the feet and legs

• Complex Regional Pain Syndrome (CRPS) — often treated successfully with DRG stimulation

• Post-surgical pain, such as lingering knee pain after a replacement

• Joint pain in the shoulder, hip, or knee that cannot be addressed surgically

• Rib pain and intercostal neuralgia after trauma or surgery

• Certain headaches, by placing stimulators at the base of the skull

Because the technology has evolved, neuromodulation is now a solution for many pain conditions that were once considered “untreatable.”

What Is the Procedure Like?

Neuromodulation is done in two stages: a trial and, if successful, a permanent implant.

Step 1: The Trial Phase

• A thin lead is inserted through a needle into the epidural space (for spinal cord stimulation) or placed near a peripheral nerve (for PNS).

• The lead is connected to an external stimulator that you wear for about one week.

• You’ll test the device during daily activities, adjusting settings with the help of a company representative.

• If you notice meaningful pain relief — most patients do — you return to the clinic for the device to be removed with just a Band-Aid.

At MAPS Centers for Pain Control, about 85% of patients who try the device go on to permanent implantation.

Step 2: The Permanent Implant

If the trial is successful, you’ll return for the permanent procedure:

• Spinal Cord Stimulator: Usually requires two small incisions (about 1–2 inches each).

• Dorsal Root Ganglion (DRG) Stimulator: Small, ¾-inch incisions are made at the targeted nerve root levels (often L4 or L5) where the tiny electrodes are placed, and another 2-inch incision connects the leads to the internal battery.

• Peripheral Nerve Stimulator: Requires only a small incision (about 1 cm).

All procedures are done as outpatient surgeries under light sedation.
Most patients recover in one to two weeks and resume normal activities quickly.

“It’s a minimally invasive and fully reversible procedure,” Dr. Lubenow notes. “If a patient ever wants it removed, it can be done easily — but most patients don’t, because their pain is finally under control.”

After implantation, patients often participate in physical or occupational therapy to retrain gait or movement patterns that had been altered by chronic pain — helping them rebuild strength and mobility as their pain decreases.

What Is Recovery Like?

Recovery depends on the type of stimulator:

• Spinal Cord Stimulator: Expect soreness at the incision sites for 2–4 weeks as your body adjusts to the small battery disc. Heavy lifting, bending, or strenuous spine movements should be avoided during early healing. Once healed, there are no restrictions — patients can swim, run, or exercise normally.

• DRG Stimulator: Recovery is similar to SCS, though incisions are even smaller and discomfort is typically minimal. Because DRG leads are anchored precisely, patients often resume normal activity within a few weeks.

• Peripheral Nerve Stimulator: Because the device is so small, recovery is faster and often easier. Most patients are back to normal activities within a few weeks.

Patients remain in close contact with device representatives during recovery to fine-tune the stimulation programs.

How Long Does Neuromodulation Relief Last?

Neuromodulation is designed for long-term relief.

• Battery Life: Modern devices last 7–10 years depending on usage. Replacement is simple — only the battery is changed, not the leads.

• Recharge Options: Some devices recharge wirelessly once a month with a small plate placed over the skin. Others are non-rechargeable and replaced after several years.

• Adjustability: Programs can be updated, much like an iPhone software update, without replacing the device.

Even if your pain changes over time, device reps can reprogram your stimulator to address new patterns of pain.

Will the Device Be Noticeable?

Most patients find the device unnoticeable in daily life.

• The incision heals into a thin scar.

• The battery disc is placed in areas where it won’t press against a chair or bed.

• Unless you’re very thin, others won’t see the device.

For peripheral nerve stimulators, the implant is even smaller — about the size of a pinky fingertip — and placed discreetly under the skin.

Why Is Neuromodulation Exciting?

Neuromodulation represents a major leap forward in pain medicine.

• It speaks the language of nerves, using targeted electrical impulses to quiet pain at the source — and in the case of DRG stimulation, it does so with unmatched precision.

• It offers new hope for patients who have already tried medications, injections, and even surgery without relief.

• It allows people to regain basic joys — sleeping through the night, walking their dog, playing with grandkids, or returning to work — without constant pain.

As Dr. Pontinen explains, “The people who get these devices have tried everything else. To see how this technology can literally change lives is incredible.”

Is Neuromodulation Covered by Insurance?

Yes. Neuromodulation is widely accepted and covered by all major insurance providers, including Medicare and most commercial plans.

• Spinal Cord Stimulation (SCS): Considered standard of care for decades.

• DRG Stimulation: FDA-approved and covered by most insurers for CRPS and focal nerve pain.

• Peripheral Nerve Stimulation (PNS): Also well-studied and covered for specific chronic pain conditions.

At MAPS, we perform several neuromodulation procedures each week, and our team handles all insurance verification before moving forward.

What Kind of Results Can I Expect?

Every patient’s experience is unique, but results are often life-changing. Patients frequently report:

• Sleeping through the night for the first time in years

• Reduced pain while walking, shopping, or exercising

• Improved ability to care for children or grandchildren

• Returning to work or hobbies once thought impossible

At MAPS, we emphasize realistic goals: reducing pain to a manageable level so you can focus on life again. Complete elimination of pain is not always possible, but meaningful relief almost always is.

Frequently Asked Questions

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