A spinal cord stimulator (SCS) is a small device surgically implanted under
your skin. A thin wire carries electrical impulses from a programmable
pulse generator to the nerve fibers of the spinal cord. The SCS can be
turned on or off. The SCS stimulates the nerves in the area where your
pain is felt. Pain is reduced because the electrical impulses modify and
mask the pain signal from reaching your brain. Stimulation does not eliminate
the source of pain; it simply interferes with the signal to the brain.
The amount of pain relief varies for each person.
The SCS device generates an electric field to modify nerve conduction of pain signals to the brain. Some SCS devices use a low-frequency current to replace the pain sensation with a mild tingling feeling called paresthesia. Other SCS devices use high-frequency or burst pulses to mask the pain with no tingling feeling. Stimulation does not work for everyone. Some patients may find the sensation unpleasant. In other cases, it may not cover the entire pain area. For these reasons, a 5-10 day trial stimulation session is required before the device is permanently implanted.
Patients with chronic and severe neuropathic pain who have not responded to other more conservative treatments may be good candidates for SCS. Common examples include patients with lower back pain from failed back surgery, radiculopathy (leg or arm pain), diabetic neuropathy, and reflex sympathetic dystrophy.
The procedure takes place at an ambulatory surgery center. The trial uses a temporary spinal cord stimulator system. If you experience an increase in activity tolerance or significant decrease in pain medication or some combination of both and a 50-70%reduction in pain, the trial is deemed successful.
