Backfield in Motion

Spinal cord stimulation relieves post-surgical back pain.

James R. Tyner, Sr., 64, earned his bad back. His painful condition developed due to a slow build-up of damage from years of overuse and abuse, and – according to James – years of trying to act young.

Dr. Mark Fallows of Pain Institute of Central Florida in Lecanto treated James Tyner for back and leg pain using burst spinal cord stimulation.

James R. Tyner, Sr.

“I was a volunteer firefighter for thirty-seven years, and growing up, I worked with my dad selling and working on appliances,” James reveals. “Then, I had my own patient transport company, so I used my back to lift people, and sometimes, I couldn’t lift properly. I also refereed high school football for twenty-five years, so I deserved my bad back.”

James doesn’t recall injuring his back, but he does remember that it would go out on him every so often. Over time, as he continued his activities, James’ back became more unstable.

“I ended up having spinal fusion surgery on my lower back in August 2011,” he relates. “I did fine after that and was able to maintain my normal lifestyle, including refereeing football. Then a disc above the fusion ruptured, and I required a second surgery in December 2012.”

Following his second surgery, James had little trouble with his back. That changed in late 2017 when he began experiencing extreme discomfort in his low back and into both legs. Again, he doesn’t recall any initiating event.

“Somehow, my sciatic nerves became pinched, and I had terrible pain in my back that shot down my legs, stopping at my knees,” James describes. “The pain was sharp and stabbing. I put ice and heat on my back, trying to relieve the pain. Sometimes, a hot shower helped.

“Eventually, the pain got so bad, I was forced to use a cane to walk. We had passes to Walt Disney World®, and I toured the park in a wheelchair. I couldn’t walk for more than a hundred feet without excruciating pain. At its worst, it was a ten on a scale of one to ten. I had to give up refereeing, something I love, because I just couldn’t do it anymore.”

As James’ pain intensified, he tried several treatments, including physical therapy, injections and pain medications, without lasting relief. But he wasn’t interested in a third surgery, so his surgeon recommended pain management specialist Mark Fallows, DO, of Pain Institute of Central Florida.

Dr. Fallows is uniquely qualified to manage his patients’ complex pain issues. He is certified by the American Osteopathic Board of Anesthesiology and the American Board of Interventional Pain Physicians (ABIPP), which has certified fewer than 400 physicians nationally. Dr. Fallows is the only physician in Citrus County who is board certified in interventional pain management. He has served area residents since 1990.

“I saw Dr. Fallows the first time August 8, 2018,” James remembers. “By then, I was taking six pain pills a day and still having terrible pain.
Dr. Fallows asked me if I had ever considered spinal cord stimulation. I hadn’t because I’d never heard of it. He explained all about stimulators, and I said, That sounds like something that would really help me. Let’s go for it.”

Phenomenally Better

A spinal cord stimulator is an implanted device that distorts pain signals going to the brain, blocking pain sensations. It is most often considered once patients begin suffering functionally due to their pain.

For years, spinal cord stimulators worked by replacing pain with a tingling sensation called a paresthesia. Many patients found that sensation too strong to tolerate, however, so a new generation of stimulator providing very little sensation, or none at all, was developed.

“This newer technology is called burst stimulation, and it takes care of vast amounts of the patient’s pain, but it doesn’t replace it with anything,” Dr. Fallows informs. “Previously, we tried to mask pain with another sensation. With burst stimulation, we are not masking it anymore, and that makes patients much happier.”

Approved by the Food and Drug Administration in October 2016, the burst stimulation device has proved to be a hit with patients who had been using older models. In one study, patients who had been using traditional stimulators were asked to try the newer technology and compare the two. Seventy to 80 percent preferred burst over the traditional stimulators. One reason is that burst does a better job of relieving back pain.

“The burst stimulator is seventy percent more effective than the old unit at reducing pain,” Dr. Fallows reports. “That’s a huge increase. If there were a treatment in medicine that improved outcomes by twenty percent, we’d think that was incredible. Here, we have a technology that’s seventy percent better. That’s phenomenal!”

Another benefit of spinal cord stimulation is that patients are given a trial run of the treatment before the devices are permanently implanted. Dr. Fallows followed that protocol with James, who was given a burst stimulator for his trial run.

“Dr. Fallows first taped the temporary stimulator to my back, and I wore it for a week to make sure stimulation would help me, which it did,” James confirms. “I was amazed by how much I could do without my back hurting. Dr. Fallows implanted the permanent stimulator on October 29, 2018, and I’m doing exceptionally well.Dr. Mark Fallows of Pain Institute of Central Florida in Lecanto treated James Tyner for back and leg pain using burst spinal cord stimulation.

“I hardly have any pain now. On a bad day, my pain level is two, but on a good day, it’s zero. I’m only taking one half of a pain pill at night now, down from six a day, and I’m working to get off the pain medication altogether.”

Easy Rider

Since James received his spinal cord stimulator, he can’t believe the difference in his quality of life.

“It’s amazing,” he raves. “For one thing, I’m sleeping better, and when I sleep better, everything else feels better, as well. As for football, I realized that referees sometimes get knocked down, and I decided I didn’t need to get knocked down, so I didn’t go back to refereeing. But I can do many of my other activities.

“We’ve been back to Walt Disney World, and I walked the entire time at the park. Last Saturday, I took my grandson to a festival, and we walked around for seven hours. I never would’ve dreamed of doing that a year ago. Before, I couldn’t ride my motorcycle because it aggravated my back. Now, if it’s not raining, I’m riding. It’s my favorite activity.

“I definitely recommend Dr. Fallows and Pain Institute of Central Florida. I’ve told people who are discouraged and want to give up to look into a spinal cord stimulator. It’s made a huge difference in my life.”

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