Frequently Asked Questions
Please note: This information is intended as a guide only and does not take the place of professional medical advice. You should see your healthcare professional for advice about the treatment and management of your condition.
All of this information is subject to the specific instructions contained in the Patient Manual received after the implantation of a device. The Patient Manual contains instructions and warnings specific to each particular model, and must be read thoroughly.
- What is chronic pain?
- How is pain registered in the brain?
- What is neuropathic and nociceptive pain?
- What are implantable pain therapies and how do they work?
- How will my doctor know if I am a candidate for implantable pain therapies?
- Is psychological evaluation a requirement for patient selection?
- What is the average length of the hospital stay?
- On average, how long does the surgery take?
- Is spinal cord damage a possible complication?
- How big are the incisions?
- Between which vertebrae is the catheter/extension (depending on therapy received) placed?
- Can a previous abdominal incision be used to implant the device?
- Are there other side effects associated with placing the catheter/extension (depending on therapy received) in the spinal cord?
- What is EMI/RFI?
- Will my device be affected by household appliances?
- If I have a device implanted, can I travel?
- How is the therapy paid for?
Chronic Pain
What is chronic pain?
If you have suffered from pain for more than three months without relief from medical and/or surgical care, then your pain may be classified as chronic. Chronic pain may result from a previous injury long since healed, or it may be from an ongoing condition. Unlike acute pain, chronic pain serves no useful purpose in protecting the body. It can also cause psychological and social difficulties.
How is pain registered in the brain?
When you feel pain, it is a reaction to signals that are transmitted from the site of pain. These signals are sent via the nerves in the spinal cord to your brain, where you perceive them as pain.
What is neuropathic and nociceptive pain?
Neuropathic pain is caused by damage to nerve tissue and is often felt as a burning or stabbing pain. Nociceptive pain, on the other hand, is caused by an injury or disease outside the nervous system. It usually feels more like a dull ongoing ache or pressure.
What are implantable pain therapies and how do they work?
Implantable pain therapies include intrathecal drug delivery and neurostimulation for the relief of chronic pain. They are proven, effective and reversible treatment alternatives that may be suitable when other pain treatments prove unsatisfactory or produce unmanageable side effects. Results may vary depending on the patient.
Intrathecal drug delivery and neurostimulation work directly on the spinal cord, which is the highway for pain signals. These therapies are thought to work by interfering with pain signals before they reach the brain.
If you are interested in implantable pain therapies, you should talk to your doctor about a referral to a pain specialist.
How will my doctor know if I am a candidate for implantable pain therapies?
Your pain specialist can do a screening test to help predict whether implantable pain therapies will relieve your pain. Many doctors believe that a 50 per cent reduction in pain indicates a positive screening test.
Is psychological evaluation a requirement for patient selection?
Psychological factors have a significant influence on many chronic pain disorders. Psychological evaluation can help identify psychological 'risk' factors; facilitate treatment of these risk factors; facilitate patient selection; and provide insight into a patient's response to a screening test or treatment.
What is the average length of the hospital stay?
Depending on your doctor's preference and hospital policy, a hospital stay of one to three nights may be recommended.
On average, how long does the surgery take?
Times vary depending on individual doctors and their technique. On average, the procedure takes one to two hours. Your doctor should be able to give you a better indication of the duration for your procedure.
Is spinal cord damage a possible complication?
Although very rare, spinal cord damage is a possible complication of these procedures. Damage also may occur from the formation of a mass at the tip of the catheter for intrathecal drug delivery, which may require surgery to correct. In very rare instances, when a mass is left untreated, it may cause paralysis.
How big are the incisions?
The abdominal incision is about 10cm (4 inches) long. This is where the implantable device is placed. There also is an incision made on your back that is about 2.5cm to 7.5cm (1-3 inches) long. This incision is used to place one end of the catheter/extension (depending on the type of therapy received) into the spinal cord. The other end of the catheter/extension is tunneled under the skin and connected to the implanted device.
Between which vertebrae is the catheter/extension (depending on therapy received) placed?
This depends on your specific condition and the results of your trial. Your doctor will advise you of the recommended location.
Can a previous abdominal incision be used to implant the device?
Usually not. The incision needs to be made at the implantation site to help anchor the device properly. Keeping the device in place will help to minimise your discomfort and speed recovery.
Are there other side effects associated with placing the catheter/extension (depending on therapy received) in the spinal cord?
In some cases, you may experience a 'spinal headache'. This is caused when cerebrospinal fluid (the fluid that surrounds your spinal cord) leaks from the intrathecal space (depending on therapy received). The headache may correct itself, or your doctor may treat it. A spinal headache may occur following the trial and/or following the device implant.
What is EMI/RFI?
EMI stands for electromagnetic interference. RFI stands for radio frequency interference.
EMI includes all forms of electromagnetic fields, while RFI includes electromagnetic fields within a specific range of the electromagnetic spectrum. RFI generally consists of higher-frequency EMI (i.e. RFI is a subset of EMI).
Any electrical device has the potential to generate and/or be affected by EMI or RFI. The allowable levels of EMI/RFI that a product can generate are controlled by regulatory agencies (in Australia, the Therapeutic Goods Agency).
Examples of products that generate EMI are motors from power tools, arc welders, mobile phones, and the security systems found in retail stores, libraries, airports, etc. Products that generate RFI can include garage door openers, CB and ham radios, microwave ovens, radio transmitting towers, radios, speakers, mobile phones, antennae, and television dish systems.
Will my device be affected by household appliances?
Normal items such as microwaves, phones, television, etc. will not affect your device and you may continue to use them as normal.
If I have a device implanted, can I travel?
You should notify your doctor/clinic of your travel plans. Your doctor will tell you about any necessary prescription adjustments and when you must return to the clinic. He or she may need to make a referral before your departure.
If your pump will need to be refilled or your neurostimulator programmed while you're away, you or your doctor can visit the Find a Physician section of this website to find an appropriate physician where you'll be travelling.
How is the therapy paid for?
If you are an Australian resident or a category of visitor to Australia who is eligible for the Australian Medicare program, this information should apply to you, however, you should talk to your doctor about funding options for the device and associated medical costs.
If you have hospital level private health insurance, the device is considered a prosthesis and generally should be fully funded. You will need to check your policy for any waiting periods, exclusions or excess payments that may be required. The hospital procedure will be funded by Medicare and your private hospital insurance to the amount specified by the Medicare Benefits Schedule. You should check with your doctor about any additional fees and charges.
If your pain is due to an accident, you may be eligible for treatment under a compensation scheme such as WorkCover, motor traffic accident compensation arrangements or other insurance. You should check with the appropriate insurance scheme or your doctor about this.
If you do not have private hospital insurance and are not eligible for compensation under insurance arrangements, you may be able to receive treatment as a public patient, however, this may incur a waiting period. You should check this with your doctor.
There are provisions to minimise the out-of-pocket medical expenses for Australians. These include the Medicare Safety Net for out-patient procedures, the Pharmaceutical Benefits Safety Net and taxation rebates for medical expenses. You should check with Medicare about these.
