Spinal Cord Stimulation For Chronic Pain

What is Spinal Cord Stimulation (SCS) Therapy for Chronic Pain?

Chronic pain is an unpleasant pain sensation that persists for more than 3 months and all treatment options exhausted in a bid to relieve the pain. Some of these conditions includes Failed back surgery syndrome (FBSS), Post-laminectomy pain, Complex regional pain syndrome (CRPS).

Spinal cord stimulation (SCS), like the pacemaker (neurostimulator) for the heart, is implanted under the skin – either in the upper buttock, upper chest wall or abdominal area. The neurostimulator is then connected to a lead or leads and it generates electrical pulses to your nerve in your spinal cord to provide pain relief.

Before the neurostimulator is actually implanted, a trial is performed to allow the patient to assess the response to spinal cord stimulation therapy as the therapy effectiveness may vary from patient to patient.

The patient has the opportunity during the trial, to experience the neurostimulation effects, get comfortable with it and observe if it helps to control the pain. Usually, the evaluation period can be from 5 days and may last up to 10 days at your physician’s discretion. SCS trial is considered successful when the patient experiences adequate pain relief during the trial period. Only when there is significant sustained relief during the trial period, will the neurostimulator generator be implanted (usually in the buttocks or the lateral abdominal wall).

How Spinal Cord Stimulation for Chronic Pain Works?

Spinal cord stimulation therapy provides pain relief by blocking the pain and changing the pain signals before it reaches the brain. The neurostimulator generates 24 hours of electrical impulses to block unpleasant pain signals using signals that mimic brain impulses at the spinal cord level.

Spinal Cord Stimulation (for Chronic Pain) Procedure

Spinal cord stimulation therapy is conducted in two stage procedures. If patient is found appropriate for SCS after consultation with physician, patient must firstly undergo an evaluation (Stage 1) to assess if SCS will be a good option before proceeding to a permanent implant. If evaluation assessment outcome is successful with pain level decreases, you may proceed with a full SCS surgery (Stage 2). Spinal cord injury patients proceed on to Stage 2 immediately.

Stage 1 – SCS Evaluation
SCS evaluation or sometime is called a trial period is to allow the patient assess the response to spinal cord stimulation therapy as the therapy effectiveness may varies from patient to patient. Usually, the evaluation period can be from 5 days and may last up to 10 days at your physician discretion.

Stage 2 – Full Implant
For full implant SCS surgery, the mapped leads in the epidural space is then connected to the neurostimulator which is placed under your skin in the buttock, chest wall or abdomen. Generally, the surgery takes 2 to 3 hours and you will be discharged the next day. A set of stimulation program will programmed for the neurostimulator and patient is required to visit clinic for follow up and possible adjustments of neurostimulation program to regulate pain and regain daily activity.

Recovery with Spinal Cord Stimulation Therapy

For chronic pain sufferers: Just like any surgery, adequate recovery time is required and you can resume light activities after two to three weeks after surgery but complete recovery may take six to eight weeks. It is advisable to avoid certain physical activities during the first 3 months post-surgery as you have an implant in your body. During your recovery phase, your pain specialist will work with you for program adjustment to your neurostimulator for optimal pain coverage.

Potential short and long term improvements may include:

• Adjustable pain relief
• Minimally invasive procedures
• Reduced opioid use
• Targeted pain relief
• No systemic side effects of medications
• Long term cost effectiveness
• Alternative to oral medication
• No refills needed