Whether you're experiencing pain after back surgery or you've been dealing with pain for years and have struggled to find a solution, you may benefit from a minimally invasive procedure called spinal cord stimulation.
This spinal cord stimulation overview explains what the treatment is, how it works, and why it may be an answer to your chronic pain.
What is spinal cord stimulation?
A spinal cord stimulator (SCS) is a small medical device, similar to a pacemaker, that uses electrical impulses to mask pain signals before reaching the brain. Below are a few SCS highlights.
Spinal Cord Stimulation Highlights
- A non-drug therapy option that has been proven safe and effective.
- FDA approved for adults with chronic pain of the trunk and/or lower limbs.
- Covered by some insurers.
- Relied on by hundreds of thousands of people world wide to help manage chronic pain.
Spinal cord stimulation (SCS) results in meaningful pain relief for 50-70% percent of well-selected patients and has minor rates of complication (1).
Who is spinal cord stimulation good for?
Spinal cord stimulation is best for patients who suffer from:
- Chronic pain after back surgery termed "failed back surgery syndrome."
- Chronic pain after surgery is defined as pain that has not resolved 6 months after surgery.
- Chronic pain that has not responded to other treatments.
- Chronic pain is defined as pain that has been present for longer than 4 to 6 months and has failed to resolve with other treatments like medication management, injections, and physical therapy.
- Patients who suffer from chronic pain that radiates from the back into one or both of the legs.
- Patients that have radiating pain--or "radicular pain," commonly known as "sciatica"--have a particularly high chance for treatment success
Other conditions that can be successfully treatedwith spinal cord stimulation are:
- Chronic Sciatica or Arm Pain
- Complex Regional Pain Syndrome (CRPS)
- Failed Back Surgery Syndrome (FBSS)
- Multiple Sclerosis
Roughly 20% of patients will have persistent pain after back surgery. (2)
What is the process for getting a spinal cord stimulator?
Step 1: Evaluation by a medical doctor
If you have have chronic back pain that has failed multiple therapies or have persistent back pain after spine surgery (failed back surgery syndrome), discuss spinal cord stimulation with your interventional pain doctor.
An interventional pain doctor specializes in using non surgical, minimally invasive procedures to reduce pain. If you are unsure if you're a candidate for spinal cord stimulation you should speak with an interventional pain doctor (psst that's what we are at Beam!).
Step 2: Stimulator Trial
Before a permanent spinal cord stimulator is inserted, a trial is performed to ensure adequate pain relief. At our surgery center, temporary leads are placed into the back (image 1). Unlike the long-term implant, the temporary leads have an external stimulator device that can be easily disconnected (image 2). Over the next 3 to 7 days you will be able to see if the SCS works for managing your pain.
What defines SCS trial success?
- Your pain is reduced by at least 50%.
- You're able to return to activities that matter to you.
- Your need for pain medication is reduced.
- You're able to relax and sleep better.
Step 3: Implantation
If the trial run is successful, a minimally invasive procedure is performed to place a permanent stimulator. During the procedure, the lead wires along the back of the vertebrae are then connected to a pulse generator positioned just below the skin near the waistline (image). Most patients leave the day-of or the morning after their procedure.
Step 4: Recovery
The spinal cord stimulator is programmed before leaving the surgery center. Approximately 10 days after the procedure, the incision is checked to ensure adequate wound healing. Fine tuning of the device also occurs to ensure maximum pain relief.
Top 6 patient questions about SCS
- Q: Will the implant be visible?
- No. You will not be able to see the device under your skin. Unless you tell someone you have it, they'd never know. Your doctor can position it in the most comfortable and convenient location for you. Some patients report that they can feel the unit by pressing on their skin. In many cases, it is not visible to others.
- Q: When can I resume activity?
- For several weeks after the implant procedure, you will be asked to restrict your physical activity. The reason for this is to give your body time to heal around the battery pack and leads which keeps the system in an appropriate position.
- Is SCS Reversible?
- Yes. Even though your leads and battery pack are surgically implanted, they can be disengaged or removed by your physician, if ever needed.
- Is SCS Safe?
- Yes. SCS delivers stimulation that doesn't interfere with normal sensory perception, cognitive abilities, or motor functions. It doesn't interact with pain medications or requires major surgery, and it is completely reversible.
- What are the risks of SCS?
- Occasionally patients experience device complications, such as a displaced lead, internally fractured electrode, or device malfunction. Major complications, however, are rare. Complication rates should generally be lower in the hands of an experienced practitioner. The medical problems most often seen are bleeding at the site of the implant, or infection. In such instances, removal of the device and antibiotic treatment are generally required. Infection rates can be as low as 1%, but may rise to 4% in some centers.
Do You Think You Could Be A Candidate?
If you think you may be a candidate for a spinal cord stimulator or you're just interested in in learning more, you can receive a free online medical consultation with a Helped patient coordinator today. Your coordinator will assess if you're a candidate, and if so, will help you get connected with the best pain doctors near you.