Dorsal Root Ganglion (DRG) Stimulation

Medically reviewed by Joshua L. Hare, DO, Founder & Medical Director

Conditions Treated

Complex regional pain syndrome (CRPS),[1] post-surgical nerve pain, groin and pelvic pain, foot and ankle pain, focal neuropathic pain

Dorsal Root Ganglion Stimulation at a Glance

How DRG Stimulation Targets One Specific Area

Every sensory signal from a given patch of your body — the top of one foot, the inside of one knee, one side of the groin — passes through a small cluster of nerve cells beside the spine called the dorsal root ganglion. It is the junction box for that territory and nothing else. Placing a fine electrode lead beside the DRG at the level that serves your painful area means the stimulation lands exactly where your pain lives, rather than being spread across the broader signal traffic of the spinal cord. That anatomy is what makes the therapy precise, and it is why a dedicated DRG device exists. Animal and human studies indicate that electrical stimulation of DRG neurons can modulate neuropathic pain signals.[1]

The ACCURATE Trial: the Evidence This Therapy Stands On

DRG stimulation was tested head-to-head against traditional spinal cord stimulation in ACCURATE, a pivotal, prospective, multicenter randomized trial in 152 subjects with complex regional pain syndrome or causalgia in the lower extremities[1] — the largest prospective, randomized comparative effectiveness trial to date[1] for these two therapies.

Both arms of that trial are procedures we offer, and the comparison tells us which tool fits which patient: for focal lower-limb pain of this kind, the DRG’s precision is the better fit, while traditional spinal cord stimulation remains our tool of choice for broader, multi-area, or axial pain patterns. The consultation narrows that down, and the trial week settles it.

Trial First, Implant Second

1. Your physician maps your pain to the one or two spinal levels whose dorsal root ganglia serve that territory.
2. In a sterile procedure, temporary leads are placed beside those ganglia through a needle — no incision, no implanted battery yet.
3. You live with the trial system for about a week, at home, doing ordinary things, and track your relief.
4. If the trial delivers meaningful relief, the permanent system — leads and a small implanted battery — is placed at our ambulatory surgery center.
5. Activity is restricted for 6-8 weeks while the leads settle in; most patients are back to full activity by 8-12 weeks.
6. The device is then programmed to your pain, and reprogrammed over time as your needs change.

Risks and Side Effects

In ACCURATE's randomized comparison, no stimulation-related neurological deficits were reported,[1] and device-related and serious adverse event rates were no different from traditional SCS.[1] As with any implanted device, surgical risks exist — infection, bleeding, lead movement, or discomfort at the battery site — and your physician will walk through them with you before either stage. The trial week itself is reversible by design: the temporary leads are simply withdrawn if the therapy does not deliver.

Common Questions

How is this different from regular spinal cord stimulation?

Traditional SCS places leads along the dorsal columns of the spinal cord, which carry signals from broad regions of the body. DRG stimulation moves the target one junction closer to your pain: the ganglion that serves only the painful territory. For focal pain, that translates into coverage that is harder to miss and less likely to spill into areas that never hurt.

Will the feeling change when I sit down or roll over?

Less than with traditional stimulation. In the randomized trial, DRG patients reported significantly less postural variation in the stimulation sensation.

What if the trial does not help me?

Then the leads come out, and you have spent a week getting a reliable answer without surgery. That is the point of trialing first: the permanent implant is only offered once your own trial week has shown meaningful relief.

Where does the permanent implant happen?

At our ambulatory surgery center, as an outpatient procedure. You go home the same day, with activity restrictions while the leads anchor in.

References

Clinical sources for this page.

1. Deer TR, Levy RM, Kramer J, et al. Dorsal root ganglion stimulation yielded higher treatment success rate for complex regional pain syndrome and causalgia at 3 and 12 months: a randomized comparative trial. Pain. 2017;158(4):669–681. Back to first citation ↑