Catherine Brunschwyler's pain was unbearable.
The former nurse midwife first started experiencing bilateral foot pain several years ago on the job. She was initially diagnosed with plantar fasciitis, but as time went on, her pain became worse even as doctors tried their best to alleviate it.
"I was misdiagnosed for several years," she said. "I had every treatment imaginable - I went to a podiatrist, then my physician sent me to an orthopedist. I had every kind of injection you can think of, every kind of topical product. I had two rounds of physical therapy; I had surgery on my feet. I tried acupuncture - paid out of pocket for it - and all different kinds of medications to try to help with the pain."
Brunschwyler was then referred to Dr. Timothy Deer, the leader of the Center for Pain Relief at Thomas Health System, who suggested that her pain may not be caused by plantar fasciitis, and that there may be other ways to treat it. Eventually, Brunschwyler was diagnosed with idiopathic polyneuropathy at Cleveland Clinic, and joined the roughly one-third of neuropathy sufferers whose pain has no known cause.
Like many chronic pain sufferers, Brunschwyler was forced to rely on narcotic painkillers for several years to dull her pain - much longer than she'd ever wanted, until she was forced to go on disability in 2012.
"I was never pain-free on just the medications, and I never expected to be, after everything I'd tried," she said.
Just a few weeks ago, Brunschwyler tried something else - an implanted device called the Axium Neurostimulator System for dorsal root ganglion stimulation. The latest version of the device, approved by the FDA in February after seven years of study, targets specific areas of the dorsal root ganglion to treat localized nerve pain.
"I have half the pain I used to; it's amazing," Brunschwyler said. "I never have pain above a three or four (on the pain scale) now; it used to be an eight in the late afternoon and evening."
There's even a chance Brunschwyler could be weened off her existing pain prescriptions, although she said Deer told her the procedure "wasn't a failure" if she still needed some narcotics to fully control her pain.
"He told me if, at three months I want to start weening, to start with the narcotics and go slow and see what happens," she said. "I am a hopeful person, even though he keeps reminding me that it's not a failure if I can't get off my meds, but I'd like to be able to get off all of them."
According to Deer, alternatives to narcotics have been the focus of the Center for Pain Relief since it opened more than 20 years ago.
Deer has led research, both in the U.S. and abroad and in partnership with the FDA, on surgical implantations to relieve pain, including the DRG implant used in Brunschwyler's case. The new DRG implant is an improvement on older versions of the device, Deer said, because it offers more targeted relief - Brunschwyler had a previous version of the implant several years ago, but it was not effective in getting to the source of her pain.
"If you injure your knee after a knee replacement, if you get your foot crushed, if you get shingles in your leg - anything that results in severe nerve damage, then in the past, we've put in devices that have helped some people in the past quite a bit," he said. "But if you have pain in one specific place, they would have trouble getting that. We actually have new tool, a specially designed pacemaker wire that goes directly on the nerve - the dorsal root ganglion stimulation."
Deer said roughly 85 percent of those who receive the DRG device are able to eliminate or reduce their dependence on opioids.
"One of the things we're having good success with is taking people off addictive medicines; reducing them ... about 60 percent of the time we can totally eliminate them," he said. "It's a pretty desirable goal, and something that is really coming to the forefront."
The Center for Pain Relief has generated several "pilot studies" based on pain relief treatments its doctors originate, and if those prove successful, the treatments then become part of "multi-center studies," usually abroad where the process is faster, before returning to the U.S. for FDA approval, Deer said.
The center also offers physical therapy, occupational therapy and water therapy to its patients, as well as less invasive alternatives to some more traditional pain management techniques - roughly half of patients the center sees for herniated discs can be treated with a steroid injection directly to the disc, eliminating the need for surgery, Deer said.
"We do other procedures, too; sometimes, we'll go in and heat the areas around a joint in a procedure called radiofrequency ablation - it's like the procedure you often hear about performed on the heart, but with the spine," Deer said. "Older folks who may not be able to undergo a large surgery may choose this, and it can be very successful."
For Deer, the goal isn't to eliminate the use of narcotics entirely, but to offer as many people as possible alternatives that can reduce or eliminate their dependency on drugs while addressing their chronic pain.
"We have really tried to use interventional therapy to reduce the need for controlled substances for years," he said. "Some people need controlled substances, but the goal is to try to properly monitor those people, and to try to reduce and eliminate their need for drugs, if possible."
Reach Lydia Nuzum at lydia.nuzum@wvgazettemail.com, 304-348-5189 or follow @lydianuzum on Twitter.