Dorsal root ganglion stimulation for multifactorial refractory foot pain: A case report

Dorsal root ganglion (DRG) stimulation has emerged as an effective, targeted neuromodulation therapy for refractory pain of the lower extremities, particularly in the setting of complex regional pain syndrome. However, preliminary evidence supporting DRG for other applications, such as peripheral neuropathy or refractory nociceptive pain, is currently limited to patient populations with discrete pain sources. We report a case of chronic, multifactorial foot pain successfully treated with a right S1 DRG stimulation after failure of multiple prior interventions including physical therapy, corticosteroid injections, and surgeries.

A 74-year-old male presented with chronic refractory right foot pain, diagnosed with L5-S1 radiculopathy, peripheral neuropathy, persistent post-surgical pain following multiple procedures, including partial toe pain, which significantly impaired his mobility and quality of life. DRG stimulation was pursued after multiple prior interventions, including physical therapy, corticosteroid injections, surgeries, and a trial of peripheral nerve stimulation (PNS) that provided only temporary relief. Following a successful stimulation trial, a permanent DRG device was implanted at the S1 level, resulting in meaningful, sustained pain relief and functional improvement.

DRG stimulation represents a promising treatment for refractory lower extremity pain, especially in cases where traditional therapies have failed. This case illustrates its therapeutic potential in patients with complex refractory neuropathic pain of mixed etiologies.