Spinal Cord Stimulation for Chronic Pain Relief 

What is a spinal cord stimulator and how does it work to relieve pain? 

A spinal cord stimulator is a device that I implant in the spinal canal. It consists of two wires that sit on top of the spinal cord. Those wires are connected to a battery, like a pacemaker, which sends electrical signals through those wires to the spinal cord. When your body sends pain messages to your brain saying that your back or your leg hurts, the stimulator sends signals that interfere with those messages. When the pain messages get to your brain, they aren’t as strong. Sometimes, they don’t make it to the brain at all.  

What types of chronic pain conditions are most commonly treated with spinal cord stimulation?

The most common condition treated with spinal cord stimulation is post-laminectomy syndrome, also known as failed back syndrome, which occurs when people who have had spine surgery on their low back still have severe pain in either their low back, their legs, or both. 
 
Stimulators can also be used to treat severe diabetic neuropathy pain in the legs. 

Patients with these conditions can be good candidates for spinal cord stimulation when other treatments such as medications, injections, and surgery, have failed or weren’t an option. 

What does a spinal cord stimulator procedure entail? 

Spinal cord stimulation is unique because we get to see how well it works before we actually do surgery.  
 
The first part of spinal cord stimulation is a trial. This happens in the office procedure room. After numbing their skin, I insert two temporary wires in the patient’s back, using X-rays to guide me, until they’re sitting on top of the spinal cord. I then connect the ends of the wires to a battery which is covered up and taped to the patient’s back, just above the hip. The patient goes home like this for 5-7 days with the device running. When they return, I simply pull the temporary wires out. If the patient reports that their pain was significantly better during the trial, we schedule the permanent implant. 
 
The permanent implant happens very similarly, but the procedure is done in the operating room. This is because I need to make two small incisions so that I can bury the wires and the battery under the skin so that everything is inside the patient permanently. 

What kind of results can patients realistically expect after undergoing this treatment?

Studies show that most spinal cord stimulation patients will have their pain decrease by at least 50%.  

What is recovery like after a spinal cord stimulation procedure?

With both the trial and the permanent implant, patients go home the same day. After the permanent implant, there is typically some soreness around the surgical sites that can take a few weeks to calm down, but the pain from these incisions is generally minor. 

How has spinal cord stimulation technology evolved in recent years?

Spinal cord stimulation technology has become very impressive over time. Battery technology has improved so that the stimulator battery will now last from 7-10 years before needing to be replaced. The programming of the stimulator itself has allowed for better pain control as we now have multiple different programming modes that we can use to interrupt or otherwise change the pain signals before they get to the brain. 

What do you like best about spinal cord stimulation as a treatment option?

Most of the patients I see for spinal cord stimulation have been dealing with pain for years, have had surgery, and have been told that there’s nothing else that can be done. It’s very gratifying to see many of these patients later on and hear that they can now sleep through the night without being woken up by pain, or can walk three times farther than they once could before their leg starts to hurt. For the right patient, it can really help restore some quality of life that they’re missing.