WVU Medicine helps Albright man reclaim his life from chronic pain

MORGANTOWN, W.Va. – More than 60 million Americans live with chronic pain, including 21 million who experience daily activity limitations, according to the Centers for Disease Control and Prevention.

Nicholas Goodwin is one of the 21 million. When high-impact pain suddenly took over his life, he sought help from the experts at the WVU Medicine Center for Integrative Pain Management.

Aside from Type 1 diabetes that he successfully managed with insulin, Goodwin, a 33-year-old information technology specialist from Albright, had no other health issues. But two years ago, he unexpectedly began to experience burning pain in his feet and stiffness and numbness in his hands.

He was diagnosed with small fiber neuropathy, a condition in which damaged nerves cause burning, pain, numbness, and tingling, usually in the hands and feet. He also had erythromelalgia, a disorder affecting the constriction and dilation of blood vessels. Together, the two conditions caused a painful cycle of persistent discomfort and sudden episodes of extreme redness and swelling.

“With that pain, it was hard to do a lot of things,” Goodwin said. “I was having difficulty doing my job at work.” He noted that standing was painful, and he often tried to elevate his feet while working.

In search of drug-free relief, Goodwin visited the Center for Integrative Pain Management, where its director, Richard Vaglienti, M.D., suggested spinal cord stimulation.

“Spinal cord stimulation is exactly what it says – it stimulates the spinal cord to block pain signals,” Dr. Vaglienti said. “And we also know with relative certainty that it improves circulation.

So, when I saw him, I knew he had circulation problems – that’s part of his whole spectrum. And he had nerve pain. I knew stimulation answered both.”

The Medtronic InceptivTM spinal cord stimulator (SCS) is a small device implanted under the skin that offers personalized treatment of chronic pain. Thin wires, or leads, are placed near the spinal cord, and the neurostimulator device is implanted in the outer hip. The patient controls the stimulator with a smartphone-like device to send electrical signals to the leads, based on various settings. 

To determine if he was a good candidate for SCS surgery, Goodwin underwent a comprehensive screening process that included a behavioral evaluation, an informational session, and a week-long trial wearing an external system. 

Encouraged by the results of the trial, he moved forward with the surgery. Two leads were placed near his spinal cord – one in his neck and the other in his mid-back. 

Vaglienti said having a lead placed in his lower back and one in his neck isn’t typical of the procedure, but in this case, he felt it would help Goodwin better control the pain in his arms and legs. 

Since the surgery, Goodwin said, “It’s been amazing. I’m able to stand longer. I’m able to use my hands a lot more.” He added that he installed a new floor in his grandparents’ home on his own. 

Goodwin said he felt “understood” and “heard” when he told the WVU Medicine team that he wanted to find a solution without medication.  

“Dr. Vaglienti’s team is great, and they listen to you and listen to your concerns,” he said. 

Vaglienti said moving people from medications to other methods of pain management is one of the main reasons the Center for Integrative Pain Management exists.

“We’re looking at the highest level of function at the lowest possible achievable level of pain,” Vaglienti said. “And the spinal cord stimulator, with respect to the ability to control pain in certain situations, is fantastic.” 

To learn more about the WVU Medicine Center for Integrative Pain Management, visit WVUMedicine.org/Pain.