Spinal Cord Stimulation For Chronic Pain
November 8, 2018
What Is Spinal Cord Stimulation?
Spinal cord stimulation involves a minimally invasive procedure in order to send low voltage stimulation to spinal nerves and block the feeling of pain. This procedure is used to treat chronic pain that has failed to respond to more conventional treatments such as medications, injections, or physical therapy.
Spinal cord stimulation helps patients to better manage pain, potentially decrease the amount of medication needed, and improve functionality. A small, battery-powered generator is implanted in your body and transmits an electrical current to your spinal cord, replacing pain with a pleasant “tingling sensation.” This procedure has shown success in returning many patients to a more active lifestyle.
Conditions Commonly Treated by Spinal Cord Stimulation:
- Failed Back Surgery Syndrome (continued pain after surgery to the spine)
- Radiculopathy (pain that progresses down your arms/hands or legs/feet)
- Complex Regional Pain Syndrome (a progressive sympathetic mediated nerve process resulting in chronic pain typically in the arm/hand or leg/foot)
- Arachnoiditis (painful inflammation and scarring of the meninges or the protective wrapping around nerves)
- Other chronic pain (stump pain, multiple sclerosis, spinal cord injury, peripheral vascular disease, etc)
Time off From Work: 1-3 weeks, varies by patient
Incision: Back; 3cm
How Does Spinal Cord Stimulation Work?
This procedure requires a five-day trial to allow your physicians to verify that spinal cord stimulation will work for your pain. You will receive sedation followed by an epidural injection in the epidural space to help place a small electrode (specialized wire). This procedure is repeated as most trials require placement of two electrodes.
Once the electrodes are properly placed, a representative from the device company will turn on the spinal cord stimulator and ask you to describe what you feel. This takes anywhere from 5-10 minutes and should not be painful.
The epidural needles are removed, and the electrodes are secured to your back with tape and a few stitches. The pulse generator (battery) will be connected to the electrodes and simply taped to your back.
You should maintain your regular daily activities during the trial and continue all pain medications as prescribed. You will return to the clinic when your five-day trial is complete to talk with your physician. If you feel at least a 50% decrease in your typical pain as well as improvement in function, the trial is considered successful and you are given the option of having the stimulator permanently placed.
Permanent implantation is done only after a successful trial. If you decide to proceed with a permanent spinal cord stimulator through an outside surgeon, please refer to their specific instructions as these can vary by patient/physician.
Permanent implantation is a surgical procedure that must be done in an operating room. The procedure can be divided into two categories starting with a laminotomy (done by an outside surgeon) followed by the percutaneous implant (done by your pain physician).
What to Expect After the Procedure:
The surgical procedure itself will cause some pain. Continue taking your pain medications as prescribed. Ice packs and over-the-counter pain medications may be used for short-term pain.
Return to the clinic around 10 days after your procedure to have staples and stitches removed.
Avoid the following activities for 6 - 8 weeks to prevent electrode movement:
- Avoid any bending, twisting, stretching, or lifting anything over five pounds.
- Avoid raising your arms above your head.
- Avoid sleeping on your stomach.
- Avoid sexual activity until your first follow-up appointment.