Chronic pain can be disabling for so many people, and especially those who have failed numerous treatments. Spinal cord stimulation can provide hope and relief for many such patients. These devices work by interfering with the pain signal traveling up towards the brain. Thus, they do not “fix” the underlying problem, but they modulate the pain signal and can provide many with substantial pain relief, allowing them to decrease use of opioid medications and increase activity. Many patients who receive these devices truly feel that it has given them their lives back.
A spinal cord stimulator (SCS) is a surgically-implanted device, similar to a pacemaker, which has wires going into the epidural space that provide a small electrical signal to the spinal cord. This device is connected to a small battery (roughly the size of 3 stacked silver dollars) which is the control hub. Like a modern-day computer, these devices can be programmed and can be controlled by the patient. This means the patients can control the intensity of the stimulation, change between various programs that have several types of stimulation or various locations of pain, as well as turn the device on and off. The devices can have stimulation that is perceived by the brain and is felt like a tingling sensation in the area of pain, or they can have a high frequency signal that is not perceived by the brain, but does provide with pain relief. Most devices today can provide both types of pain relief, and can be programmed so the patient can choose which type of stimulation they want at that moment. The goal of spinal cord stimulation is to provide patients with 50-70% pain relief, yet even smaller improvements in pain can make an enormous difference in the quality of life for many.
These devices are not the first line of treatment for pain, rather for those who have failed conservative treatments such as physical therapy, oral medications, and injection therapy, and who have already had surgery or there is no surgical option available. These patients typically have severe back, neck, arm or leg pain. Spinal cord stimulation does not work for everyone, but patients can undergo a trial with temporary leads placed for 3-7 days to try the therapy and see if it works for them.
Spinal cord stimulation was first used in 1967, and has been approved by the FDA since 1989. Worldwide, there are over 14,000 of these devices placed each year. Most of the modern devices are now MRI compatible, meaning patients can still undergo MRI imaging even with these devices in place. For appropriate candidates, these devices have been life changing. A consult with a pain specialist can help determine if someone is an appropriate candidate.