If you are experiencing chronic or long-lasting pain, you are not alone. According to a by the Centers for Disease Control and Prevention (CDC) on the general health of adults in the country, about 20% (approximately 50.2 million adults) live with chronic pain.
If you are among the statistics and conservative treatment options like medication, interventional pain management, and physical therapy are not helpful, spinal cord stimulation therapy could be the answer to your problem.
The theory behind the effectiveness of this therapy option is that it blocks the transmission of pain and tingling sensations to your brain, reducing uncomfortable symptoms of chronic pain. Although this therapy option will not treat the root cause of the pain, it can help you regain your independence and go back to activities you used to enjoy for the comfortable life you deserve.
At LAMIS Institute, we understand how stressful it can be to depend on chronic narcotics as your pain relief option for chronic pain that grows more severe every day. Our Los Angeles pain doctors will explore various pain treatment remedies, including spinal cord stimulation therapy, to help you live your life optimally.
Spinal Cord Stimulator at a Glance
A spinal cord stimulator, also known as SCS, is a device that your pain doctor or surgeon will surgically place under your skin as an alternative option to relieve chronic pain. Typically, this device consists of the following parts:
- A pulse generator with batteries that help create low-level electrical signals
- Electrodes which are typically thin wires surgically implanted between your vertebrae and the spinal cord to transmit electrical signals or impulses to the spinal canal or targetted nerves
- A hand-held remote that you can externally use to send electrical impulses whenever you feel uncomfortable pain
Some SCS medical devices (traditional) use a low-frequency electric current to replace the bothersome pain sensation with a mild tingling sensation, also known as paresthesia. Other modern devices use bursts or high-frequency electric current to cover the uncomfortable pain with a non-tingling sensation.
Paresthesia or non-tingling setting is the common option on most SCS devices. However, this stimulation does not work or benefit every patient because some could find this sensation unpleasant. To determine whether or not you are an excellent candidate for spinal cord stimulation therapy, you should speak with an experienced pain doctor.
How to Know if You are an Excellent Candidate for Spinal Cord Stimulation Therapy
Generally speaking, spinal cord stimulation therapy is not for every patient. If you are here, it means you have already tried other chronic pain treatment methods without success, or perhaps you want to learn more about this common, ground-breaking pain relief option.
As with other treatment methods, your pain doctor or surgeon will want to ensure you are an excellent candidate for spinal cord stimulation therapy. To determine whether or not the SCS will work out in your favor to provide the much-needed relief to your bothersome chronic pain, your pain doctor will probably order psychological screening and imaging tests.
Also, if you have insurance coverage, your insurer could require you to undergo psychological testing to ensure disorders like anxiety or depression are not worsening or alleviating your pain. In most cases, patients selected for this therapy have had long-lasting bothersome pain in their lower back, leg, and arm for more than three (3) months.
Although every patient's pain condition is different, you could be an ideal candidate for SCS if:
- Additional surgery will not benefit you
- Conservative therapies or treatment methods have failed
- You do not have untreated addiction or psychological problem
- The pain is due to a treatable condition
- You do not have an underlying medical condition that can prevent you from undergoing surgical implantation of SCS
- You do not want extensive surgery due to the associated risks or the lengthy recovery period
- You are unpregnant
- You have already had a successful SCS trial
Types of Chronic Pain That are Manageable Through Spinal Cord Stimulation Therapy
As stated earlier, spinal cord stimulation therapy is a preferable pain treatment option that could work out to your advantage if other non-surgical and conservative pain relief methods are unsuccessful. Surgical placement of SCS under your skin can help manage or treat various types of chronic pain.
Generally, if your chronic pain is due to any of the following conditions, spinal cord stimulation therapy could be the treatment option you need to live a comfortable and optimal life:
- Diabetic Neurotherapy — This diabetic condition will often cause stabbing or burning pain in your feet or legs
- Chronic arm or leg pain (sciatica) — This is an ongoing, persistent, and bothersome pain caused by nerve damage, spinal cord injury, or arthritis
- Failed back surgery syndrome — This is the pain that persists and continues after undergoing surgery to relieve chronic pain either on your leg or arm
- Arachnoiditis — This is a painful inflammation or scarring of the thin membrane "arachnoid" that covers the spinal cord and the brain
- Complex regional pain syndrome — This is a progressive disease where patients often feel unending and long-lasting burning pain, typically in their feet or hands
- Other — Other possible causes of chronic pain that the stimulator could help manage or treat include (but are not limited to):
- Angina
- Spinal cord injury
- Multiple sclerosis
- Stump pain
- Perineal and visceral abdominal pain
Speaking with your pain doctor is key if you want to try a surgical placement of SCS devices under your skin to help manage long-lasting pain in any part of your body. Apart from being aware of your health and treatment history, your pain doctor can recommend FDA-approved medical devices for your unique condition.
Available Spinal Cord Stimulation Options
Since the Federal Drug Administration (FDA) approved spinal cord stimulation as a remedy for chronic pain, manufacturers have since continued to modify these devices to suit different patients' interests and unique pain conditions.
If you are an excellent candidate for spinal cord stimulation therapy, your pain doctor or neurosurgeon will help you choose the best and ideal SCS type or option for your unique pain condition. To that end, below are spinal cord stimulation options that could work in your favor to provide you with the pain relief that you need to live your life optimally:
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High-Frequency Spinal Cord Stimulation
Unlike traditional low-level systems that replace pain sensation with paresthesia, modern systems can provide high-frequency electrical impulses (1 kHz) that reduce or stop the pain without the tingling or buzzing sensation.
Most doctors and patients will choose this option because it offers the necessary pain relief on the first day of placement without intensive stimulation and paresthesia, which could be uncomfortable for some patients.
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Burst Spinal Cord Stimulation
Another recent spinal cord stimulation therapy you can consider for your pain relief problem is "burst spinal cord stimulation," or burst SCS. Unlike high-frequency SCS, which delivers electric impulses in a constant stream, burst SCS delivers high-frequency electric impulses in short bursts to block your brain from perceiving or interpreting the pain sensation.
Since this spinal cord stimulation option mimics how your nerves communicate naturally, it could be ideal for you if your chronic pain affects a specific part of your body.
Within these options explained above, SCSs will also offer different battery choices to patients, including:
- Radiofrequency stimulator — Although it is a less common option, this device uses an external battery (outside your body)
- Traditional implantable pulse generator (IPG) — For this battery option, surgery will be necessary to insert or remove the battery once it is dead
- Rechargeable IPG — While it works like the traditional IPG, this device's battery is rechargeable without the need for surgery
Your neurologist or pain doctor will teach you how to control or operate your devices and adjust the magnitude or intensity of the electric impulses that your stimulator delivers to the spinal canal whenever you feel pain. Different body postures could require different SCS settings. For instance, some stimulator settings work best for walking and others for sitting.
Your pain doctor will give you instructions on how to adjust these settings on your device to live your life optimally without uncomfortable pain at any moment.
What to Expect During Spinal Cord Stimulator Surgery
Determining whether or not the SCS system will work out in your favor to provide pain relief for your unique pain condition will require a two-step process. First, you must go through the trial "test drive" phase to see if the device alleviates or reduces your pain. Then, your doctor will place the device under your skin if the trial phase is successful.
Here is what to expect during these two non-invasive surgical procedures:
The Trial Phase
Before having the final SCS implant placed under your skin, placement of a trial or test drive implant will be necessary because this pain relief option is not for every patient. Since your doctor will ask you some questions regarding the point of placement where you feel adequate pain relief, you will not be completely anesthetized during this trial procedure.
After numbing the incision site, the doctor will place a catheter into the epidural space of your spine using an epidural needle. Typically, the specific location of your pain will determine where the doctor will place this catheter along your spine.
Once the catheter is in place, the doctor will attach an external power supply and programmer, typically on a waist belt, to supply power to the device. Then, the doctor will allow you to evaluate how well or effectively the device works to reduce or stop your uncomfortable chronic pain for about a week.
Your doctor will consider this trial phase a success if you feel a 50 percent or more lessening in your pain level. In that case, you can prepare yourself for the final placement of the implant device in your spinal canal.
If the trial stimulator does not reduce your bothersome pain within that period, the doctor will remove it. Then, he/she will explore other pain relief options that could work out in your favor.
The Permanent Implant Placement Phase
If the trial phase is successful, your doctor will schedule a surgery date to implant the permanent SCS under your skin. As mentioned earlier, before this surgery, you should inform your doctor about all the medications you are currently taking, including Over-The-Counter (OTC), herbal, and prescription medication. The main reason is that some drugs can slow the blood clotting process during surgery.
During your surgery date, most doctors will recommend you arrive at the hospital or clinic about two hours before the surgery time to give you ample time to fill out and complete the necessary paperwork. During this time, the anesthesiologist will also educate you on the possible anesthesia effects you should expect after the surgery, including dizziness and drowsiness.
After administering anesthesia to numb your skin, your doctor will make one incision along your buttocks or abdomen to hold the pulse generator and another small incision along your spine to place the electrodes. Your pain doctor will use a fluoroscopy machine to determine the precise position to insert the electrodes on your spine.
Once the generator and electrodes are correctly connected, the doctor will close the incisions and sterilize them. In the next 24 hours, you should begin to reap its benefits if it is well implanted underneath your skin and programmed to suit your unique pain condition.
Before you leave your doctor's clinic, he/she will show you how to shift from one program to the next using the remote for optimal pain relief that you need to live a comfortable life.
Advantages of Spinal Cord Stimulation Therapy
Generally speaking, you will enjoy several benefits once your SCS is in place. One of the main notable advantages of this procedure over other surgical pain relief options is that it is reversible. That means you can have the implanted electrodes and generator removed whenever you decide you want to discontinue the SCS therapy. Other advantages of spinal cord stimulation therapy include the following:
It Provides You With Adjustable Pain Relief Options
As mentioned in the previous paragraph, every patient's pain condition is different and unique. For that reason, the pain relief adjustment options on the hand-held SCS remote continue to grow with new models to give patients or users suitable and helpful options for their unique pain conditions.
Additionally, some new models can adjust automatically to a patient's movements to reduce or prevent unnecessary pain. Having control over uncomfortable pain is a necessary, welcome change for patients dealing with or living with long-lasting "chronic" pain.
It Can Help You Reduce Opioid Use
The instant pain relief you will experience when you opt for neurostimulation or SCS therapy as your pain relief remedy for chronic pain will allow you to reduce or stop over reliance on opioid medications for the same.
It Involves Less Invasive Procedures
Unlike most surgical pain relief options, surgical placement of impulse generators to help with spinal cord stimulation will require one incision. On the other hand, the placement of electrodes will not even require an incision. Instead, your doctor will use a hollow needle to insert it under your skin.
It Can Provide Targeted and Precise Pain Relief
If you are symptomatic or allergic to most medications, this could be the best remedy for your pain issues. Instead of ingesting drugs that probably cause constipation, sleeplessness, or other issues unrelated to chronic pain, SCS can offer you pain relief in the precise areas where you need it.
It is Cost Effective
Spinal cord stimulation therapy is also a cost-effective treatment method in contrast to other pain relief options, including non-surgical treatment options.
It Will Not Require Refills
The pain relief you will experience once the SCS is in place can continue for several years without the need for frequent doctor appointments or new pills.
On top of the above-explained advantages, SCS will also offer several other benefits to eligible patients, including:
- Allows you to take charge of your bothersome pain relief
- Pain relief is available to you whenever you need it since you can even travel anywhere with its remote
- The SCS system is portable, meaning you can resume your daily activities at home
- You can resume your favorite recreational activities like swimming, walking, or gardening
- Reduced pain can result in positive impacts on your mental outlook and general quality of life
Restrictions After Spinal Cord Stimulation Surgery
After placement of the permanent SCS implant system, your doctor could require you to adjust your lifestyle slightly to prevent the implants from moving out of position. Here are some of the "don'ts" after this surgery:
- Avoid strenuous activities, including sex and housework
- Do not drive before your follow-up appointment, which could occur within two weeks after surgery
- Do not drink alcohol. An alcoholic beverage can thin your blood, increasing the risk of unnecessary bleeding
- Do not lift anything weighing more than five (5) pounds
- Do not apply lotion or any cream on the incision site
- Do not soak the incision site in a pool or bath
- Do not remove the bandage until your doctor gives you the green light to do so
Tips to Help You Heal Fast After Permanent SCS Implant Placement Surgery
While every person heals differently after this surgery, there are ways you can increase your healing rate. Below are tips to help you heal after permanent SCS implant placement:
- Gently wash the incision site with soap and water daily
- Wash or clean your hands thoroughly before and after cleaning the incision site
- Have adequate sleep daily
- Keep up with your appointments which are vital to check the healing progress and evaluate your SCS system
In most cases, with proper care, the incision site will heal within two to three weeks after surgery. It is also important to note that some patients can experience complications after this surgery. While these complications are rare, you should speak with your doctor or neurosurgeon when you experience:
- Bleeding
- Infection, which can occur in the first two (2) to eight (8) weeks after surgery
- Dural puncture
- Device migration
- Increased pain on the incision site
- Spinal cord trauma
Common Frequently Asked Questions (FAQs) About Spinal Cord Stimulation Therapy
It is common and natural for people to ask questions before they have any implant placed in their bodies. Below are well-thought answers to some of the most common FAQs about spinal cord stimulation therapy:
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Can I Travel With an SCS Implant in My Body?
Yes, it is completely safe to fly or drive after SCS implant placement in your body. However, experts recommend switching off the device when driving. Similarly, you should turn off your stimulator when passing through the airport security criteria, but you can keep it on during your flight.
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Can I Have CT Scans or X-ray With SCS?
As long as your stimulator power is off, it is generally safe to take CT scans and X-rays whenever necessary. However, before taking any of these scans, you should let your nurse or doctor know that you have a stimulator under your skin.
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Are SCS Implants Compatible With Magnetic Resonance Imaging (MRI)?
No. An MRI is generally unsafe for you if you have SCS devices or implants in your body. Although new SCS devices could be compatible with particular MRI machine models, most stimulators are incompatible. If your stimulator is not MRI-compatible, it could be risky to undergo this scan or test with this device in your body.
Hence, you could want to communicate with your doctor ahead of time to let him/her determine whether or not this procedure will affect your SCS model.
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Can I Have the Stimulator Removed?
Yes, you can have your stimulator removed safely at any time if there is a mechanical problem, an infection at the incision site, or perhaps when you are unsatisfied with its level of pain relief.
Find a Chronic Pain Doctor Near Me
Undoubtedly, spinal cord stimulation can significantly improve your quality of life if you have chronic or long-lasting uncomfortable pain in any part of your body. If you are looking for a solution to your chronic pain problem, this device could help you go back to your usual activities to live your life optimally.
Our experienced pain doctors at LAMIS Institute are here for you if you consider having a spinal cord stimulator as your pain management solution for chronic pain. Call us at 310-734-6088 to discuss your pain condition and schedule an appointment with our doctors wherever you are in Los Angeles.
