How Does A Spinal Cord Stimulator Work?
Suffering from chronic pain? You’re not alone. Back pain is the single leading cause of disability worldwide. With so many individuals suffering, doctors and patients alike are wondering how best to address this international epidemic. For those who are looking for a long-term solution, a device known as a spinal cord stimulator (SCS) can have fantastic results. For those who aren’t medically educated, the name of this device can be intimidating. For this reason, in this month’s blog, we’re going to walk you through the question of “How does a spinal cord stimulator work?”
Who Is A Good Candidate?
While many patients find overwhelming success in their SCS treatment, every sufferer of chronic back pain could benefit. Listed below are several of the attributes that make a patient the ideal choice for spinal cord stimulation.
- Chronic pain that prevails for longer than six months and has not dissipated with more conservative treatments
- Chronic pain that is not a result of cancer
- Chronic pain as a result of complex regional pain syndrome
- Patient does not use a pacemaker
- Patient does not partake in recreational drugs
- Patient is able to give informed consent to receive the treatment
Physiologically, How Does A Spinal Cord Stimulator Work?
To outline the treatment as simple as possible, a spinal cord stimulator (SCS) is a device that is surgically placed under your skin that allows you to send a mild electric current to the nerve fibers of your spinal cord through an external control panel. When the device is activated, the nerves in the area where your pain is felt are stimulated and pain is reduced as the electrical pulses dampen or eliminate the pain signal from reaching your brain. The device doesn’t stop the source of the pain — rather it tricks the neural pathway into never signaling the brain in the traditional manner. If at any time you wish to not feel the pain-relieving effects of the SCS, you have the freedom to turn the stimulator on and off. In most cases, you will also have control over the strength of the signal, how often the device sends currents, and the width of the pulse.
Several SCS devices use a low-frequency electrical current to replace the pain that would normally be felt. The reaction to this low-frequency current is as unique as the individual, but the majority of people report feeling a fluttering or tingling sensation. The medical term for this feeling is “paresthesia.” There are now other devices that use high-frequency or “burst” of pulses in an attempt to completely mask the pain with no tingling feeling. Your surgeon will speak with you about the different options available.
What Does The Procedure Entail?
While SCS can have fantastic and life-changing results, the spinal cord stimulator is not a reasonable long-term solution for every patient. Some individuals find the tingling sensation of paresthesia to be unpleasant while others don’t feel the desired pain relief. (Note: SCS aims to reach a 50-70% reduction in pain. While complete pain relief isn’t always viable, even a small amount can significantly better a patient’s life by reducing the amount of pain medicine that needs to be ingested in order to comfortably perform daily activities.) In order to determine your receptivity to the treatment, a trial period is conducted. A local anesthetic is utilized to numb the lower back and a hollow needle is inserted into the epidural space that lies between the bone and the spinal cord. The trial lead is fed through the needle and placed over affected nerves. The external wires are connected to a generator that you’ll have control over. After this small procedure, you’ll go home with information and instructions on how to use the device and monitor its effectiveness. After four to seven days, you’ll come back to our office to discuss moving forward with the permanent SCS device.
If the trial period is successful and both you and your surgeon decide that a spinal cord stimulator is the correct choice moving forward, then the more permanent device is implanted. The surgery usually takes between one and two hours and has two components — the insertion of the lead in the epidural space and the insertion of the pulse generator in the abdomen. To start the procedure, your surgeon will lightly sedate you and have you lie on your stomach as they numb your back and buttock for where the leads and generator will be inserted. A portion of your bony arch will be removed and leads will be secured in this space. At this point, the surgeon will wake you and test several of the stimulation patterns of the SCS to determine if the placement of the leads was correct. Once both you and your surgeon are confident about the effectiveness of the placement, sedation will be given once again. The surgeon will make a small incision below the waistline in order to place the pulse generator beneath the skin. The lead wire is attached to the generator, correctly placed, and then the incision is closed and dressed.
Most patients are able to be sent home either the same day or the day after surgery with instructions on how to care for the areas that were operated on. You will be asked to come back for a postoperative visit in order to address any issues you may have and check in on the treatments’ effectiveness.
At US Pain & Spine Institute, we work with each patient to find effective and long-lasting treatments for back pain. We are dedicated to finding innovative solutions for every individual who walks into our office. Schedule a consultation with a back pain expert today.