Thanks to an uncommon use of a fairly common pain control technology — peripheral nerve stimulation — there’s relief in sight for 42-year-old Mick Pfortmiller who has suffered from knee pain for more than 16 years.
Peripheral nerves are those that aren’t in the brain or spinal cord.
Osteoarthritis and injuries from a couple of accidents left the Somonauk construction supervisor with chronic pain in both knees.
He has undergone 14 surgeries, including reconstruction of the ACL ligament and several arthroplasties.
He’s also had periodic cortisone injections, completed countless hours of physical therapy and taken pain medications.
The pain persisted.
But Pfortmiller is young for a total knee replacement, which might only last about 20 years.
Pfortmiller’s family physician, Kenneth Kavanaugh, of Edward Medical Group in Sandwich, told him it was time to consult a specialist in pain medicine. He made an appointment with Dr. Mohammad Khan, who also is a member of the Edward Medical Group and a board certified specialist in interventional pain medicine with the Edward Neurosciences Institute.
Dr. Khan recommended a neurostimulating implant, a technique that’s been commonly used for back and other types of pain, but very rarely for knee pain.
“In cases like this where conventional treatments have failed, a neurostimulator can be a good alternative,” Khan says.
The stimulator implant is done in two stages.
First, there’s a trial that lasts about a week, in which an electrode is inserted through tiny catheters under the skin.
It’s placed near the nerve and attached to an external power supply.
“The neurostimulator is like a pacemaker for the nerves,” Khan says. “It sends the nerve a signal that converts the pain to a pleasant sensation.”
If the trial stimulation is effective, a permanent implant is scheduled. During that procedure, the power source and an electrode are implanted in the patient’s body. The patient is sedated but awake enough to guide the doctor in the precise placement of the electrode.
Pfortmiller’s trial provided the green light, and Khan did the implant for his left knee at Edward Hospital on Jan. 3.
“When the stimulator was turned on, it turned the pain off almost instantly,” Pfortmiller says. “Then I only felt slight pain in that knee from the three small incisions that were made. But that got better in a couple of days.”
If needed, he’s able to adjust the amount of stimulation with a hand-held controller, but says he hasn’t had to change the setting in a month.
One of the first things Pfortmiller asked after the procedure was, “When can I have the other knee done?”
His right knee isn’t as bad as the left was, but he still hopes to schedule his second implant soon. He’s already realizing benefits from the first implant at work, at home and in his role as a coach with the Aurora Raiders 14U girls softball team.
“It’s been fantastic,” he says. “I can keep going longer without having to rest because of the pain, and I’ve cut back a lot on the pain meds.”
And the father of three teenage girls adds, “I’m easier to get along with now, too.”
For more information, visit www.edward.org/mohammad-khan-md.
Health Aware is a weekly column courtesy of Edward Hospital.