Pain & Neuromodulation

For patients whose pain is no longer controlled by medication, injections, therapy, or prior procedures, neurosurgical and neuromodulation options can provide targeted relief. Dr. Barone evaluates each case around the pain generator, anatomy, prior treatment response, goals, and the safest available path.

Pain and neuromodulation pathway

From pain mapping to durable management

1

Goals

Clarify pain relief, function, sleep, medication burden, and quality-of-life priorities.

2

Mapping

Identify whether symptoms follow a nerve, spinal pathway, facial pain syndrome, or broader pain pattern.

3

Treatment review

Review therapy, medications, injections, blocks, surgery, imaging, and prior response.

4

Option selection

Choose stimulation, intrathecal pain therapy, lesioning, nerve surgery, or continued non-surgical care.

5

Trial or procedure

Use trials when appropriate, or proceed with the selected targeted treatment plan.

6

Long-term care

Adjust programming, dosing, refills, precautions, and follow-up over time.

Goal-directed care

Treatment planning starts with pain relief, function, sleep, medication burden, and quality-of-life goals.

Selective options

Surgery is considered when medication, therapy, injections, or conservative care are not enough.

Adjustable follow-up

Stimulation and pump therapies require ongoing management to keep treatment aligned with goals.

When conservative treatment is not enough

If nerve-related pain, spine-related pain, facial pain, or pain after nerve injury has not responded to medication, injections, therapy, or prior procedures, options such as spinal cord stimulation, DRG stimulation, peripheral nerve stimulation, intrathecal pain therapy, or selected lesioning procedures may help. The right choice depends on careful evaluation of symptoms, goals, and risks.

Treatments & procedures

  • Trigeminal neuralgia and trigeminal neuropathic pain care
  • Spinal cord stimulation, DRG stimulation, and peripheral nerve stimulation
  • Intrathecal pain pump evaluation
  • DREZ lesioning for selected brachial plexus avulsion pain

Conditions & treatments we cover

Intrathecal Pain Pump

An intrathecal pain pump delivers pain medication directly to the spinal fluid for carefully selected patients with severe cancer-related or chronic pain that has not been controlled with other treatments.

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Trigeminal Neuralgia

Trigeminal neuralgia causes sudden, electric facial pain that can be triggered by talking, chewing, touch, or brushing teeth, and selected patients may benefit from targeted neurosurgical treatment.

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Trigeminal Neuropathy & Anesthesia Dolorosa

Trigeminal neuropathy and anesthesia dolorosa are complex facial pain conditions that can cause burning, numb, painful, or deafferentation-type facial pain after nerve injury or prior procedures.

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Neuropathic Pain

Neuropathic pain is pain caused by nerve injury or dysfunction, often described as burning, electric, shooting, or hypersensitive pain that may require targeted neuromodulation or nerve procedures.

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Spinal Cord Stimulation

Spinal cord stimulation is an implantable neuromodulation option for selected chronic pain conditions, using electrical stimulation near the spinal cord to reduce pain signals and improve function.

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Dorsal Root Ganglion (DRG) Stimulation

Dorsal root ganglion stimulation is a targeted neuromodulation option for selected focal neuropathic pain conditions, especially pain that follows a specific limb or regional pattern.

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Peripheral Nerve Stimulation

Peripheral nerve stimulation is a targeted neuromodulation option for selected focal nerve pain conditions, using electrical stimulation near a peripheral nerve to reduce pain.

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DREZ Lesioning for Brachial Plexus Injury Pain

Dorsal root entry zone (DREZ) lesioning is a specialized neurosurgical option for selected severe deafferentation pain after brachial plexus avulsion injury.

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Request an evaluation with Dr. Barone

New patients and referring physicians are welcome. Patients from outside Houston, across the United States, and internationally are welcome.