For people suffering from some types of chronic pain, a treatment called spinal cord stimulation (SCS) may hold the key to relief. Referred to by some experts as a “pacemaker for pain,” spinal cord stimulation for chronic pain is now a widely accepted treatment for pain. For some patients, success rates are as high as 75%.

What are the conditions treated with spinal cord stimulation for chronic pain? 

Spinal cord stimulation is a treatment that involves sending low-voltage electrical currents to the spinal cord and the nerves sending pain signals. This process halts the pain signals and alleviates discomfort. Spinal cord stimulation can be used for a multitude of pain conditions and symptoms, especially those related to nerve pain or damage. The most common conditions treated with spinal cord stimulation include:

The therapy is also being researched for possibly treating multiple sclerosis and paraplegia.

What is a spinal cord stimulator implant? 

Spinal cord stimulation for chronic pain works by sending small electrical impulses via thin, flexible lead wires to the site of pain. Rather than the perception of pain, you will perceive a slight tingling or buzzing sensation known as “paresthesia.” Many patients report that parathesia is a pleasant feeling, and is certainly far more desirable than the pain they had previously felt.

Debuted in the 1960s and known then as dorsal column stimulation (DCS), spinal cord stimulation technology was researched in a patient group of 500 for a period of five years. The original implants didn’t show much success, due to technology issues, inexpert implanters, and poor patient selection, among other factors. The last implant of the DCS was performed in 1973.

By the 1980s, stimulator technology had improved and was more similar to the technology used today. Percutaneous leads were developed, dual multipolar lead systems were utilized, and in 1999, Dr. Giancarlo Barolat replaced the name dorsal column stimulation with spinal cord stimulation. You can find out more about how this technology is continuing to develop at the International Neuromodulation Society website.

The permanent spinal cord stimulation device consists of thin, flexible lead wires that are attached to a small battery pack. The battery pack is placed in a small, subcutaneous (under the skin) pocket, unnoticeable except for an extremely small scar. The battery pack is small in size – a bit bigger than a book of matches, but smaller than a deck of cards. The patient will also have a small hand-held remote to control how much stimulation they’re receiving.

What You Need To Know About Spinal Cord Stimulation For Chronic Pain | PainDoctor.com

Am I eligible for a spinal cord stimulator implant?

To be eligible for spinal cord stimulation for chronic pain, the patient must go through a standard process. You must first try conservative methods. Conservative methods may include but are not limited to:

  • Medication management
  • Hot and cold therapy
  • Acupuncture
  • Chiropractic treatment
  • Biofeedback
  • Minimally-invasive procedures, such as injections

A psychiatric and psychological assessment is also required by insurance companies and occurs to ensure the patient is mentally capable of using the device. Quality of the pain is assessed (is it continuous, sharp, burning, aching, etc.) by the pain doctor to discriminate whether the spinal cord stimulator would be helpful in the alleviation of the patient’s pain.

Once these measures have been exhausted, a patient may be considered eligible for spinal cord stimulation. Effectiveness for spinal cord stimulation varies from person to person, and so the procedure is broken down into two parts—a trial period followed by a more permanent solution if the trial effort is successful.

Trial period

Trial periods for spinal cord stimulation involve a doctor making a small incision into your skin and inserting a temporary electrode inside. The entire outpatient procedure takes about one hour.

The electrical impulse generated by the electrode is controlled through a stimulator that the doctor will show you how to use. The stimulator is small, and you can carry it much like you carry a cell phone. During the weeks following the trial implantation, you’ll be able to test out the treatment and see if spinal cord stimulation for chronic pain works for you.

Patients that experience a reduction in pain by at least 50% are offered the more permanent treatment, according to the National Institutes of Health. If the trial is deemed successful by both the patient and the pain doctor, a permanent device may be considered.

Watch as one pain doctor implants a trial device in the video below.

When is it not advised?

As Spine-Health explains, spinal cord stimulation for chronic pain is not advised if you have:

  • Infection at the site of the implanted device
  • A demand-type cardiac pacemaker
  • Severe depression or other psychiatric condition
  • Untreated bleeding disorders
  • Untreated drug addiction issues

How is a spinal cord stimulator implanted? 

The second part of the implantation process is a permanent procedure. This is an outpatient procedure that is typically completed with a local anesthetic and sedative to ensure your comfort. The spinal cord stimulator generator is placed under the skin, along with coated wires that are linked to nerves or placed inside the spinal canal.

Although most patients are able to return home the same day as the procedure, others are kept at the hospital overnight. During the recovery period, you must care for the incision site and take it easy for a few days, refraining from lifting, stretching, bending, or twisting. Walking or other light exercise is recommended to speed the healing process and build strength.

After spinal cord stimulation surgery, life returns to normal. Most patients don’t notice the devices after their body heals.

Your doctor will help you determine the appropriate strength of the electrical current. By using the stimulator, you’ll have the ability to control the treatment frequency and duration. Typically, people use the stimulators for one to two hours, anywhere from three to four times each day.

Will spinal cord stimulation for chronic pain work for me? 

Spinal cord stimulation shows the most promise for patients who suffer from nerve-related pain or damage.

Also, patient success for spinal cords stimulation is heavily influenced by how soon the therapy becomes available to them, research says. Although the success of treatment varies depending on the person and cause of chronic pain, research has shown that spinal cord stimulation is most effective when started quickly after the onset of pain.

Researchers at the American Academy of Pain Medicine found success rates as high as 75% for people who received a