Harriet Alexander Sydney Morning Herald.
Published: October 14, 2015 6:34PM
Every minute of the night and day, for decades, Jaswir Grewal was in pain.
The constant ache in his back forced him to leave his jobs as a mechanic and banana grower. The pain troubled his sleep, made him irritable with his wife, depressed about his prospects and rarely left his thoughts. At times, he said, it felt like more than he could bear.
“It was like a bad toothache and a migraine all mixed in together. But those things are temporary and this was 24/7,” he said.
“They put me on painkillers to stop the idea of depression or, dare I say, suicide, because something like that will push people tothat point and I’ve been near there. It has been like that.”
Until this week. Early on Tuesday morning, doctors at the Royal North Shore Hospital fitted Mr Grewal with a spinal implant that is already being heralded as a breakthrough in treating chronic pain – even though he was the first human to be fitted with a permanent version of the device.
The Saluda implant was inserted within the spinal canal, about five millimetres from the spinal cord. From there, the implant sends an electrical current through the nerves to provide relief in the area of the body that is experiencing pain.
Unlike conventional spinal implants, which are prone to giving patients electric shocks or dropping out of range when the person changes posture, it also has the unique ability to record signals back from the nerves immediately after they have been stimulated, and adjust its level of impulse.
“Nobody has ever been able to record these kinds of signals before, or do anything about them,” said pain specialist Dr Charles Brooker, who oversaw the operation and has no commercial arrangement with the manufacturer.
“It’s a breakthrough, because it means that the level of pain relief people get, day to day, will be much better with this device.”
Chronic pain affects one in five Australians and costs $34.5 billion per year.
The number of prescriptions for the painkiller oxycodone has surged fivefold over the past 10 years and pain
medication has overtaken heroin as the opioid most likely to result in death by overdose.
Saluda was the product that inspired NSW Health Minister Jillian Skinner to establish a medical devices fund to
develop and commercialise products that have the potential to make an impact globally.
Clinicians at the Royal North Shore pain clinic told her about the device in 2010, while she was in opposition, and the chances of it being taken offshore or failing to be realised through a lack of funding.
“I said, ‘That’s ridiculous – this Saluda has the potential to be bigger than Cochlear’,” Mrs Skinner said.
“It led me to believe the government had a responsibility to assist these researchers to try and get their work to the point where it could be commercialised.”
The NSW government tipped $5 million into the development of Saluda through the medical devices fund, which will be reinvested once the company is profitable.
Spinal implants are suitable for patients suffering pain from nerve damage, with around 60,000 sold each year.
Saluda chief executive John Parker said his implant, which will initially cost about $30,000, had the capacity to reach a market 10 times the size of the current one and had the potential to help patients with other nerve conditions, including Parkinson’s disease and overactive bladder syndrome.
“Saluda is founded on the idea that you can’t improve what you can’t measure and these pain management devices have been around for a long time but they really haven’t show a lot of improvement,” said Mr Parker, who was formerly an executive director at Cochlear.
“We decided we would set about measuring the activity at the nerve that’s being stimulated.
“It’s like trying to hear a whisper in the middle of a gunshot. The stimulus is a million times stronger, at least, than the tiny little response that comes back from the nerve.”
Mr Grewal’s pain grew after he had surgery to fix some ruptured discs in the 1970s, patched over the years by
painkilling drugs and a period of about eight years in the 1990s when he was fitted with an implanted pump that
But he had to have the pump removed when it threatened to rupture, which gave him severe withdrawal symptoms, and pushed him back on to painkilling drugs.
Before the device was fitted on Tuesday, Mr Grewal rated his pain about eight out of 10. By midmorning,
it had dipped to a two or three.
“If that,” he said. “It’s a significant decrease in pain. I’m so excited about it.”
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This story was found at:http://www.smh.com.au/national/health/saludaspinalimplantforpainreliefheraldedasbreakthrough20151014gk7s9c.html