Spinal cord stimulation for chronic pain is a minimally invasive treatment that uses an implanted device to interrupt pain signals from reaching the brain. It is an effective peripheral neuropathy treatment and also helps reduce chronic pain in the back, neck, leg or arm. Also called neurostimulation, the implanted device uses electrical impulses to reduce or eliminate the sensation of pain. The electrical impulses are delivered via tiny leads that are attached to the spine and powered by a small pacemaker-like generator that’s implanted under the skin in your abdomen or upper buttocks. Patients receive a wireless remote that allows them to control the amount of stimulation being delivered, since chronic pain isn’t always constant.
Spinal cord stimulation was first approved by the FDA in 1989 for the treatment of chronic pain. But early devices were limiting. Today, spinal cord stimulators, including the Boston Scientific models our Neurosurgery One Denver spine surgeons use, are smaller, safer, and more convenient. As such, they’re being used to treat even more types of chronic pain when conservative therapies don’t provide relief.
Frequently Asked Questions About Spinal Cord Stimulation
Continue reading below to learn more about spinal cord stimulation, or click to go directly to the question you are interested in.
- How does spinal cord stimulation use electrical impulses stop chronic pain?
- What kind of pain does spinal cord stimulation help?
- How do I know before getting spinal cord stimulation if it will stop my chronic pain?
- How is spinal cord stimulation performed?
- What is recovery like after spinal cord stimulation?
- How much pain relief does spinal cord stimulation provide?
- What is parasthesia and how does it work in spinal cord stimulation?
Conditions Treated with Spinal Cord Stimulation
How does spinal cord stimulation use electrical impulses stop chronic pain?
Spinal cord stimulation doesn’t cure pain. Instead it fools the brain into not recognizing it. The way it does this is by sending tiny pulses of mild electric current through the leads to specific nerves on the spinal cord. These impulses mask pain signals traveling to the brain, so then your brain doesn’t recognize the pain.
Because pain is typically not constant, you can turn stimulation on and off and choose the level of stimulation you want. Spinal cord stimulation also can target different pain signals coming from different parts of your body.
What kind of pain does spinal cord stimulation help?
Spinal cord stimulation is used to treat chronic pain caused by a wide variety of conditions, including:
- Back or neck pain
- Failed back surgery syndrome
- Post-surgical pain
- Angina, or chest pain, not treated through cardiovascular interventions
- Spinal cord injury
- Diabetic neuropathy and other types of nerve pain
- Peripheral vascular disease
- Complex regional pain syndrome
- Post-amputation pain (phantom limb pain)
Spinal cord stimulation can even treat multiple pain sites simultaneously, making it a good option for people with more than one type of chronic pain.
If you’ve tried conservative treatment (physical therapy, massage, pain medication, injection therapy, etc.) or even surgery for any of the above conditions without lasting relief, you may be a candidate for spinal cord stimulation. Pain must not be associated with or made worse by a psychological disorder such as anxiety or depression. Most insurance plans require a psychiatric evaluation prior to treatment with spinal cord stimulation.
How do I know before getting spinal cord stimulation if it will stop my chronic pain?
If your Neurosurgery One physician believes you could benefit from spinal cord stimulation, the next step is a trial period. During the trial, your physician will insert the electrical leads into your spinal cavity through a hollow needle. The leads will be attached to an external battery pack that you’ll wear on a belt. Your physician will then instruct you on how to use the remote to turn the stimulation on and off, increase and decrease the level of stimulation, and target different pain areas.
Spinal cord stimulation trials last anywhere from a few days to a week. If you experience pain relief during the trial period, you can decide to have the spinal cord stimulator implanted during a surgical procedure. Approximately 90% of patients who undergo a spinal cord stimulation trial move forward with surgical implantation. The spinal cord stimulator implant is permanently placed but can be removed if you should ever want that.
How is spinal cord stimulation performed?
If your spinal cord stimulation trial relieves your pain and you decide to move forward with the implanted device, you will be scheduled for surgery at a nearby outpatient surgical center or hospital. During the procedure, you will be sedated and your surgeon will place thin leads, similar to the ones used during the trial phase, into your spinal cavity. You’ll then be woken up to ensure the leads have been placed in the exact right area to provide pain relief.
Once lead placement is confirmed, you’ll be sedated again while your surgeon implants the generator under your skin in your abdomen or upper buttocks. This generator, which is about the size of a silver dollar, will not be visible from the outside. After your surgeon connects the leads to the generator, the incision will be closed, and you’ll be taken to a recovery area. The entire procedure takes about 1-2 hours, and you go home the same day.
What is recovery like after spinal cord stimulation?
Patients who have a spinal cord stimulator implanted can expect to return home the day of surgery and should rest for the remainder of the day. Some patients may feel pain from the incision, but this generally goes away in 1-2 weeks.
Patients can resume light activity in about two weeks after the surgery. To avoid unintentionally displacing the leads, you’ll need to limit bending and strenuous activity, including lifting anything over 10 pounds, for six weeks following your procedure. Your neurosurgeon will provide you with specific instructions on what activity to avoid.
The spinal cord stimulator will begin working immediately after the system is programmed the day of the procedure.
How much pain relief does spinal cord stimulation provide?
The goal of spinal cord stimulation is to reduce pain by 50-75%. Because every person experiences pain differently, results vary. One reason it’s important to conduct the trial is to ensure that you experience enough pain relief to get the permanent implant.
Neurosurgery One uses the Boston Scientific spinal cord stimulation system. More than 100,000 people have received a Boston Scientific spinal cord stimulator for the treatment of chronic pain. A full 95% of these patients stated in a survey they would recommend the procedure to a friend. And their pain relief is long-lasting. In a major clinical trial, patients reported an average six-point drop in pain (from 8.6 to 2.98) two years after receiving the stimulator.
What is parasthesia and how does it work in spinal cord stimulation?
Spinal cord stimulation sometimes uses a gentle tingling or fluttering sensation to replace the pain. This is called parasthesia. Other devices use high-frequency or burst pulses to mask the pain with no parasthesia. The device used by Neurosurgery One spine surgeons in Denver offers several settings that allow patients to choose how much parasthesia they want.