Spinal cord Stimulation: Beyond Pain Relief, a journey Through Learned Helplessness
A new spinal cord stimulator offered one patient a dramatic reduction in chronic pain, but the path to optimal relief revealed a deeper psychological hurdle: learned helplessness. Chronic illness often breeds a sense of powerlessness – a common experience for those living with long-term illness.
Last February marked a turning point for one individual whose life had been significantly limited by chronic pain. The implantation of a spinal cord stimulator brought not only considerable pain relief,allowing them to return to work,attend their child’s graduation,and even rediscover sensation in their feet,but also a surprising desire to break free from the cycle of frequent medical appointments.
The patient acknowledged the difficulty in finding a pain management specialist who truly listened and respected their self-reported experience, attributing it largely to luck. Even with a good provider, the bi-monthly clinic visits – and the associated reminders of potential opioid addiction – felt burdensome. “It took years to find a pain doc who trusts me as a reporter of my own experience, and it was mostly luck that got me there,” they stated. while acknowledging the responsible use of opioids under clinical supervision, the patient felt the 28-day monitoring schedule, after nearly a decade of use, had become excessive.
The initial success with the stimulator allowed the patient to gradually discontinue opioid medication.Prior to the device, pain levels consistently hovered between 5 and 6 out of 10. afterward, they typically experienced pain at a 3 or 4, manageable with over-the-counter ibuprofen and ice. This newfound freedom – “drug-free, clinic-free, doctor-free” – was the ultimate goal.
However, six weeks ago, a call from Abbey, a sales representative for the stimulator company, disrupted this newfound independence. The patient learned that periodic clinic visits were required to adjust the stimulator’s programming.Initially hesitant, due to past “medical trauma,” the patient eventually agreed to an appointment. They emphasized Abbey’s professionalism and kindness, but initially anticipated a brief, perfunctory check-in.
That expectation proved drastically wrong. Abbey, rather than simply confirming the patient’s positive experience, believed there was room for improvement. Using a remote device connected to the implanted battery pack and a tablet, she began meticulously adjusting the stimulation parameters. The patient described a bizarre sensation – “sparkles in my right thigh and the next, creepy crawlies on my left calf.” Abbey explained her goal was to expand the sensation to encompass the entire legs, lumbar spine, and even lower ribs, creating what she termed “stim pants.”
After a 90-minute session, the adjustments were complete. The result was described as a revelation. having already endured countless treatments – “barked up a forest’s worth of trees, meditated over every crystal, had major surgery, regenerative injections, 40 zillion different physical therapists” – the patient hadn’t imagined further improvement was possible. They realized they had unknowingly deprived themselves of nearly a year of even greater pain relief.
This realization prompted a deeper introspection, leading to the identification of a psychological phenomenon known as learned helplessness. Defined as “when an individual continuously faces a negative, uncontrollable situation and stops trying to change their circumstances, even when they have the ability to do so,” learned helplessness explained why the patient hadn’t proactively sought further optimization of their treatment.
The patient was speedy to emphasize that this wasn’t self-blame, but rather a logical consequence of prolonged struggle and exhaustion. “This is not my inner critic pointing a finger. I don’t blame myself or anyone else with chronic illness for this experience,” they stated. They acknowledged the cyclical nature of chronic illness – periods of active fighting interspersed with periods of retreat.
Despite the possibility that the stimulator may eventually lose its effectiveness, the patient remains optimistic.For now, they are experiencing a level of pain relief previously unimaginable and have scheduled a follow-up appointment with Abbey in three months to explore further optimization. “In the meantime, I’m sitting here with less pain than I’d ever imagined possible. And I’m putting in a calendar reminder to call Abbey back in three months to see if it can get even better.”
