Pain Management Procedures
Dorsal Root Ganglion Stimulation
Dorsal Root Ganglion Stimulation
What is DRG stimulation?
The dorsal root ganglion, or DRG, is a cluster of sensory nerve cells beside a spinal nerve root. DRG stimulation places small leads near selected ganglia to target pain in a more focused body area than traditional spinal cord stimulation may cover. A battery sends programmable electrical signals through the leads.
Who may be considered?
FDA-approved DRG systems are indicated for moderate to severe chronic, intractable pain of the lower limbs in adults with CRPS type I or II. Clinicians also study or use DRG stimulation in selected focal pain conditions, but those uses may be off-label. “Any chronic back or leg pain” or routine knee pain is too broad a claim; the diagnosis, prior treatment, and device labeling matter.
What happens?
Like SCS, treatment begins with a temporary trial. Leads are placed through needles under X-ray guidance and connected to an external programmer. If the trial produces meaningful improvement in pain and function, permanent leads and a generator may be implanted. Screening, psychological evaluation, insurance authorization, and discussion of alternatives are typically required.
Recovery and daily life
Activity is restricted during the trial and early implant recovery to protect the leads. The system is adjusted over several visits. Patients receive device-specific instructions about charging, MRI scans, driving, travel, and procedures that use electrical or magnetic energy.
Important risks
Risks include infection, bleeding, spinal-fluid leak, nerve injury, lead movement or fracture, implant-site pain, device malfunction, and reduced effectiveness over time. A successful trial improves the odds of benefit but does not guarantee a permanent result.
Preparing for your injection procedure…
Your instructions will depend on the procedure. Before any injection, tell the APG team if you:
Take aspirin, warfarin, clopidogrel, apixaban, rivaroxaban, or another medicine or supplement that affects bleeding. Never stop a prescribed blood thinner unless the clinician who manages it and the procedure team tell you how to do so safely.
Have diabetes, glaucoma, a bleeding disorder, an active infection, fever, or recent antibiotic treatment.
Could be pregnant, have an allergy to contrast dye or local anesthetic, or have reacted to steroid injections before.
Use an implanted pacemaker, defibrillator, spinal cord stimulator, or other electrical device.
Some procedures require fasting, a medication adjustment, or a responsible adult to drive you home, especially when sedation is planned. Follow the instructions provided for your specific appointment.
After your injection procedure…
Most injections are outpatient procedures. Mild soreness, bruising, temporary numbness, or a brief increase in the usual pain can occur. Follow the activity and bandage instructions you receive. Steroid medicine may take several days to have an effect and can temporarily raise blood sugar.
Call the office promptly for increasing redness, drainage, fever, severe or rapidly worsening pain, or new numbness or weakness. Seek emergency care for trouble breathing, chest pain, sudden loss of bladder or bowel control, a severe new headache, loss of vision, stroke-like symptoms, or rapidly progressing weakness.
This information is for general education and does not replace medical advice, diagnosis, or treatment. Not every procedure is appropriate for every patient, and results vary. Your APG care team will review your symptoms, examination, imaging, medical history, medications, and prior treatment before recommending a plan. Coverage requirements also vary by insurance plan.