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What Is Spinal Cord Stimulation?

A spinal cord stimulator (SCS) is an electric nerve blocker implanted into the spine. It is designed to disrupt your body’s signals to report pain, often replacing those signals with a more tolerable sensation, such as a mild tingling or paresthesia.

How Does a Spinal Cord Stimulator Work?

The implanted device sends low levels of electricity into the spine, disrupting the bioelectric signals your nerves use to pass information up the spinal column to reach the brain. This process often replaces the pain sensation with a mild tingling sensation or sometimes eliminates the pain, providing significant relief from chronic pain.

What Can Spinal Cord Stimulation Treat?

Spinal cord stimulation can treat chronic pain across the body, particularly when other treatments have failed or when the injury or defect causing your chronic pain cannot be identified or repaired with surgery. It is often used after non-surgical nerve block injections fail to relieve pain.

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Do I Need Spinal Cord Stimulation?

If you have been struggling with chronic pain for three months or more and other treatments have proven ineffective, you may be a candidate for implantation of a spinal cord stimulator. Before the operation, your pain specialist will conduct several tests to locate the source of your pain, helping to make the nerve blocker more effective.

A psychological assessment may be conducted before the procedure to ensure that psychological factors do not impede the treatment’s success and enhance overall outcomes. Some medical insurance providers also require a series of psychological tests before implanting the spinal cord stimulator.

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What Can Spinal Cord Stimulation Help Relieve?

Spinal cord stimulation can help relieve discomfort from (but is not limited to) the following conditions:

  • Abdominal pain
  • Chronic back pain (especially if it persists after a surgical operation)
  • Chronic leg pain
  • Chronic arm pain
  • Cancer pain
  • Phantom limb syndrome
  • Burning or stabbing pain in the legs or feet (diabetic neuropathy)
  • Complex regional pain syndrome
  • Inflammation and scarring of the spinal nerves
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How Is Spinal Cord Stimulator Surgery Done?

There are two stages to implanting a spinal cord stimulator.

Stage 1: Trial Run

The first stage of spinal cord stimulator surgery involves a trial run, allowing you and your physician to determine whether the spinal cord stimulator effectively reduces your pain before committing to a permanent implant. During this trial phase, temporary leads are placed in the epidural space of your spine. These leads are connected to an external stimulator, which you’ll wear for several days to a week.

The trial run is performed under local anesthesia, and the leads are positioned using fluoroscopy (real-time X-ray) to ensure precise placement. You’ll have the opportunity to adjust the stimulation settings to find the most effective level of pain relief. Throughout the trial period, you’ll be asked to monitor your pain levels and report any changes to your physician.

If the trial run successfully manages your pain, you’ll proceed to Stage 2: Permanent Placement,where a fully implanted device with a power source is positioned under your skin.

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Stage 2: Permanent Placement

Once your doctor confirms that electrical nerve disruption reduces your pain, the final device will be implanted with a power source (similar to a pacemaker).

The operation is conducted under local anesthesia. Depending on where the implanted device will be attached to your spine, a single incision above your buttock or lower back will be used. The battery is usually placed above your buttocks or in your abdomen.

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What Are My Regenerative Therapy Options?

The Advanced Relief Institute offers regenerative medicine treatments for patients seeking less invasive options before considering spinal nerve blocking. These include platelet-rich plasma (PRP) therapy, stem cell injection therapy, and amniotic fluid injection therapy, which can promote healing and pain relief by harnessing the body’s natural ability to repair and regenerate tissues.

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Is There a Recovery Period After Spinal Cord Stimulation?

Patients should refrain from exercise (except for brief walks) for one to two weeks to allow the implanted device to settle and function optimally. After two weeks, most patients can return to work and resume driving (with the nerve blocker turned off). Full recovery from the surgical implantation of the spinal stimulator typically occurs within two to four weeks, with a gradual return to more intense physical activity as advised by your physician.

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Spinal Cord Stimulation FAQ

What is the purpose of the spinal cord stimulator trial?

How long does the trial phase last?

What can I expect during the trial procedure?

Is the trial procedure painful?

What happens if the trial is successful?

What if the trial doesn’t relieve my pain?

Are there any risks or side effects associated with the trial?

How does spinal cord stimulation compare to other pain management treatments?

Can I resume normal activities during the trial?

What is the purpose of the spinal cord stimulator trial?

The spinal cord stimulator trial is designed to test whether spinal cord stimulation effectively reduces your pain before committing to permanent implantation. This trial phase allows you to experience the potential benefits of the treatment, helping you and your physician decide if it’s the right long-term solution for your chronic pain.

How long does the trial phase last?

The trial phase typically lasts several days to a week. During this time, you’ll wear an external stimulator connected to temporary leads in your spine. This period allows you to assess the effectiveness of the stimulation and make any necessary adjustments to the settings.

What can I expect during the trial procedure?

The trial procedure is minimally invasive and performed under local anesthesia. Temporary leads are placed in the epidural space of your spine, which is connected to an external stimulator you’ll wear throughout the trial period. The procedure is generally well-tolerated, with most patients experiencing only mild discomfort.

Is the trial procedure painful?

Most patients report minimal discomfort during the trial procedure. A local anesthetic is used to numb the area where the leads are placed, and the procedure is relatively quick. After the procedure, you may experience some soreness at the insertion site, but this typically subsides within a few days.

What happens if the trial is successful?

If the trial run reduces your pain, you’ll move on to stage 2: permanent placement. During this stage, a fully implanted device, including a power source, will be placed under your skin, typically in the lower back or abdomen. This permanent stimulator will be connected to the leads in your spine to provide ongoing pain relief.

What if the trial doesn’t relieve my pain?

If the trial does not provide the expected level of pain relief, the temporary leads will be removed, and you and your physician will discuss alternative treatment options. The trial is a valuable diagnostic tool that helps determine whether spinal cord stimulation is right for your pain management.

Are there any risks or side effects associated with the trial?

While the spinal cord stimulator trial is generally safe, there are some risks and potential side effects. These may include temporary soreness or bruising at the insertion site, minor bleeding, or, in rare cases, infection. It’s important to follow your physician’s instructions closely during the trial period to minimize these risks.

How does spinal cord stimulation compare to other pain management treatments?

Spinal cord stimulation offers a unique approach to pain management by directly targeting the nerves that transmit pain signals to the brain. Unlike oral medications, which can have systemic side effects, spinal cord stimulation provides localized pain relief with fewer overall side effects. It’s also less invasive than many surgical options and can be adjusted or reversed.

Can I resume normal activities during the trial?

During the trial period, it’s important to avoid strenuous activities, particularly those that involve bending, twisting, or heavy lifting, to prevent the leads from shifting. However, most patients can continue with light activities and are encouraged to assess how well the stimulator manages pain during their daily routine.

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