You may not know this, but individuals who suffer from stroke commonly see the muscles surrounding their shoulder become weaker and weaker and their shoulder gradually dislocates from the socket.
When this happens, it is extremely painful, and the patient -- because of the stroke -- often lacks the ability to express the pain because they've been rendered mute by the stroke itself.
Additionally it is not uncommon for the stroke itself to damage the pain-sensing system which results in a magnification of an already extremely painful syndrome!
The Stimrouter is a small, thin wire that is implanted with a needle in the shoulder next to the axillary nerve. It is then tunneled to the surface just underneath the skin where, on the outside of the arm, a tiny patch is placed to transmit electrical signals down to the nerve for two reasons: 1) to activate the deltoid muscle, which then relocates the humorous bone into the shoulder joint stopping the dislocation, and 2) to actually block the signal of pain that is transmitted to the brain from the shoulder itself.
The appropriate candidate, first and formemost, is any stroke patient who has shoulder pain. Additionally, the Stimrouter has also been approved for stimulation of any nerve in the trunk or extremities for any nerve-related pain. Click here for a patient testimonial.
While the shoulder pain isn't necessarily associated with nerve damage in the shoulder, it is associated with the the nerve damage in the brain itself and the consequence is an extremely painful syndrome called shoulder hand syndrome.
Regarding sciatic nerve pain, the Stimrouter is not the best tool in the bag for these issues, but there are many other types of implantable devices for sciatic pain that work extremely well. Many of those are standard spinal cord stimulator devices, but also dorsal root ganglion stimulator devices and many others.
When patients ask how they can relieve the shoulder pain after a stroke, we have been having great difficulty for many years treating this problem. Usually we brace the shoulder or put the shoulder into a sling, but this very poorly treats the underlying problem. And that is why the Stimrouter is such a revolutionary concept and product.
Shoulder pain from other causes such as labral tears and rotator cuff tears and arthritis are probably still best served by an orthopedic surgeon.
However, as technology advances, if we can get better and better at blocking pain, we may be able to treat shoulder pain itself without surgery in the future.
W. Porter McRoberts, MD
Interventional Spine and Pain Medicine