Burst Out of Back Pain

New spinal cord stimulator helps to find comfort zone.

Through all the years she worked in retail, Linda Nelson’s biggest worry about a job-related health issue was aching legs from being on her feet all day. She never anticipated the bizarre accident that occurred in October 2001 that left her back and legs in ruins.

Photo by Jordan Pysz.

Thanks to the stimulator, Linda can vacuum the floor without pain.

“A truck driver was bringing in a pallet of merchandise, and as I was coming from the office, I heard, Watch out!” Linda recounts. “But it was too late, and the pallet fell on top of me. The pain in my back was instant, and it also shot down my legs.
“When I stood up and tried to walk, I felt okay, but the district manager took me off work and sent me to the doctor and a neurologist. I ended up getting all this hardware put in my back because it turned out my spine was unstable.”
The surgery gave Linda’s spine some much-needed stability, but it did little to relieve her pain. In fact, her pain only intensified.
“I could hardly stand up or stand in one spot,” she relates. “Then the doctors found out the rods and screws from the hardware they put in my back were loose. I had to have a second surgery to remove them in 2002.
“Then in 2003, they were going to put some type of cage in my back because, again, my spine wasn’t stable. But once the surgeon started the operation, he just sewed me back up without putting in the cage. He said, You need to retire, so I did.”
A few years later, Linda had a fourth surgery on her back, but still she continued to suffer from excruciating pain. Eventually, the pain began interfering with many of her daily activities.
“I still did housework, but it wasn’t easy,” she describes. “I had to stop between tasks. Instead of getting it done in one day, it took me two days. I love to cook, but instead of getting a meal out in one morning, I had to prepare it the day before so I wouldn’t have to stand on my feet so long.”
Linda visited her doctor repeatedly throughout all this, and they tried various therapies aimed at relieving her back pain, but with little success. Finally, her doctor referred her to pain management specialist Mark Fallows, DO, of Pain Institute of Central Florida. Serving area residents since 1990, Dr. Fallows is uniquely qualified to manage complex pain issues. He is certified by the American Osteopathic Board of Anesthesiology and the American Board of Interventional Pain Physicians (ABIPP). ABIPP has certified fewer than 400 physicians nationally. Further, Dr. Fallows is the only physician in Citrus County who is board certified in interventional pain management.

Secret Weapon

One of Dr. Fallows’ secret weapons for pain relief is the spinal cord stimulator, an implanted device that distorts pain signals going to the brain. The device is an upgrade on older stimulators that replaced pain with a tingling sensation called a paresthesia. Many patients found that sensation too strong, however, and couldn’t tolerate it.
“The newer stimulators have very little sensation, or none at all,” explains Dr. Fallows. “This 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. Previously, we tried to mask pain with another sensation. We’re not masking it anymore, and that makes patients much happier.”

“Before I got the stimulator, I couldn’t even walk in the
grocery store. But now, I don’t even need a cart.” – Linda

Dr. Fallows notes that the spinal cord stimulator is not a first-line treatment for back pain. It is generally offered after many other therapies have been tried and failed, which was the case with Linda. He adds that it is most often considered once patients begin suffering functionally due to their pain.
“When back pain is impairing a patient’s ability to engage in the activities of daily living, it’s time to try the implant,” he confirms. “If patients can’t make it through the grocery store or if there’s a chance they can no longer live independently, they’re perfect candidates for the spinal cord stimulator.”
Though she was suffering from pain that radiated from her back all the way down to her ankles, Linda wasn’t eager to try the spinal cord stimulator when she first started to see Dr. Fallows four years ago. “I wasn’t ready for anyone to touch my back because of the four surgeries,” she says. “But in 2017, my back got really bad. I couldn’t walk around the block; I couldn’t walk two houses. I couldn’t make it through the grocery store, and I couldn’t sleep at night. It even got to the point that my sister had to help me get out of a chair. That’s when I told him I was ready.”
Linda’s timing was just right. Approved by the Food and Drug Administration in October 2016, the burst stimulation deviceGraphic courtesy of Abbott. 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 new 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,” verifies Dr. Fallows. “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!
“In addition, with the older stimulators, if patients coughed, sneezed or lay on their backs, the sensations from the stimulator became stronger. That’s called positionality, and the new technology doesn’t have it.”

Walking Farther

Before October 2001, Linda never thought she’d appreciate walking as much as she does now. For years, walking any distance left her in agony. Thanks to her spinal cord stimulator, she is now able to walk longer and father without intense pain in her back shooting down her legs. Linda’s doing other activities she struggled with previously as well.
“Before I got the stimulator, I couldn’t even walk in the grocery store. But now, I don’t even need a cart,” she enthuses. “When my sisters and I go to the grocery store, we can park out in the lot and walk instead of using the handicapped spots.
“I can also make my bed and vacuum the floor; I just have to be careful. I can clean my house with no problem, and it doesn’t take me two days to prepare dinner. With the stimulator, my pain level is fifty percent better than it was. It’s awesome.
“I absolutely suggest the spinal cord stimulator for people in similar circumstances as me, and I definitely recommend Dr. Fallows and Pain Institute of Central Florida. I’m feeling great, thanks to them!”

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