Dorsal Root Ganglion (DRG) Stimulation

The following is for general educational purposes only; I no longer accept referrals for DRG stimulation.


Dorsal root ganglion (DRG) stimulation is a minimally invasive, safe, and effective therapy for certain forms of neuropathic pain. The procedure is an alternative to a related procedure called spinal cord stimulation. 

Many chronic pain conditions are neuropathic, meaning they are due to abnormal electrical activity in part of the nervous system. Both DRG stimulation and spinal cord stimulation work by delivering carefully targeted pulses of electricity to scramble pain signals - but they differ in where these pulses are targeted. Spinal cord stimulation delivers these pulses to the spinal cord, while DRG stimulation delivers them to a different structure called the dorsal root ganglion. 

DRG stimulation has an advantage over spinal cord stimulation in that pain relief can be very targeted. The human body has two DRGs - one on either side of the body - at each level of the spine. Each DRG provides sensation for a limited part of the body. The foot, for example, is supplied by the L5 and S1 DRGs. In this way, DRG therapy can be isolated to only the part of the body affected by pain.

 
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DRG stimulation works best for pain that is isolated to a particular body part. Some of these body parts are difficult to reach with traditional spinal cord stimulation. Examples of pain conditions suitable for DRG stimulation: 

  • Groin pain after hernia repair. 

  • Hip or knee pain after a joint replacement. 

  • Foot or ankle pain after surgery, trauma, or a nerve injury. 

  • Testicular pain. 

  • Pelvic pain. 

  • Nerve injuries affecting the abdomen, pelvis, groin, or legs. 

  • Complex regional pain syndrome (CRPS).

  • Causalgia.

Like spinal cord stimulation, DRG stimulation is performed in two stages. Both are outpatient procedures (no hospital stay). 

The first stage is referred to as a trial. Stimulator leads are inserted using a needle. The patient trials the therapy for one week at home to see if it helps the pain. The leads are then removed in my office. 

For patients who have significant pain relief from the trial, a second procedure is scheduled. This procedure is very similar to the trial; stimulator leads are inserted using needles at the same levels of the spine, but this time they are connected to a small battery that is implanted under the skin.