Spinal Cord Stimulation for Chronic Back Pain
SCS is a good modality for patients that have exhausted all conservative and medical options for their arm or leg pain that is neuropathic in nature. If a patient has already tried medication, physical therapy and injections without any sustained relief, then this is worth considering. Patient will have to have an MRI of the spinal area where the lead will be located as well as a psychosocial evaluation before we will be able to proceed.
What Is Neurostimulation?
Neurostimulation (also called spinal cord stimulation, or SCS) is a proven therapy that has been recommended by doctors to manage chronic pain and improve quality of life. Neurostimulation systems are approved or cleared by the U.S. Food and Drug Administration (FDA) for the management of chronic pain in the back, neck, arms, or legs. They are also covered by many major health insurance plans, Medicare, and workers’ compensation programs.
Credit (required): Photo courtesy of Duke University
Benefits of neurostimulation may include:
A reduction in pain by 50 percent or greater.
A reduction or elimination in the use of pain medications.
Increased activity levels and an improved overall quality of life.
Neurostimulation, however, is not a cure for what is causing the pain and does not treat specific diseases. Instead, it is a therapy that's designed to mask pain by blocking pain signals before they reach the brain. It has been used to manage pain that comes from failed back surgery syndrome (FBSS) or post-laminectomy syndrome and other neuropathies. To find out if neurostimulation may be right for your pain, talk to your doctor.
How Does Neurostimulation Work?
Neurostimulation works by intercepting pain signals before they reach the brain. To do this, a small system is implanted within the body. This system, similar to a cardiac pacemaker, is used to replace pain with a different feeling. Some people describe this feeling as a gentle massaging sensation or, in some cases, simply the absence of pain.
Pain signals travel up the spinal cord to the brain.
A generator sends pulses to a lead (a thin wire).
The lead delivers these pulses to nerves along the spinal cord.
The pulses block the pain signals before they reach the brain.
The painful feeling is replaced with a more pleasant sensation.
What is Spinal Cord Stimulation (Neurostimulation Therapy)?
Spinal cord stimulation is delivered with a small spinal cord stimulator—similar to a pacemaker—that is implanted under the skin. The neurostimulator delivers mild electrical pulses to your spine, causing a tingling sensation in the area of your chronic pain.
How Spinal Cord Stimulation Works
Spinal cord stimulation provides pain relief by modifying the pain messages before they reach the brain. The neurostimulator sends out mild electrical pulses that reach the brain faster than the pain signal can arrive. In other words, it outsmarts your back and leg pain. Instead of feeling pain, you feel a tingling sensation.
You can adjust the strength and location of stimulation using a handheld programmer. For example, you can regulate different levels of stimulation at different times of the day or for various activities, such as walking, sleeping, or sitting.
With SCS therapy, a small implantable pulse generator (or IPG) and thin wires (leads) are placed in the body. The leads then deliver tiny pulses to the nerves that mask pain signals as they travel to the brain, producing a tingling sensation, which reduces the feeling of pain. Doctors call it "paresthesia." You call it relief.