What is Spinal Cord Stimulation?
Spinal cord stimulation, also known as spinal cord neuromodulation, is a pain management procedure that results in the delivery of low-level electrical signals to the spinal cord or specific nerves to block pain signals from reaching the brain. Spinal cord stimulator devices consist of two parts: the stimulator leads, which are thin wires with an array of electrodes at the tip, and the stimulator pulse generator, which is a small, pacemaker-like battery pack. A single lead, or in some cases two leads, are inserted into the epidural space via a needle introducer. The epidural space is the space right between the spinal cord and the vertebrae, surrounded by protective dural tissues.
During the “Stimulator Trial” period, the leads are then connected to an external battery pack, which controls the pattern and intensity of stimulation for up to a week, during which time you judge the effectiveness of the therapy, and decide in consultation with your doctor if you want to proceed with the “Permanent Implant” of the system. If we proceed, the stimulator pulse generator is surgically placed under the skin, usually near the buttocks or abdomen. Spinal cord stimulators can be programmed to run continuously, or to allow patients to control the electrical impulses using a remote control when they feel pain.
Traditional spinal cord stimulators replace the sensation of pain with light tingling, or comfortable paresthesia. For patients who find these sensations irritating, newer devices offer “sub-perception” stimulation that cannot be felt.
What is spinal cord stimulation used for?
Spinal cord stimulation is used most often after other interventional, surgical and medication-based treatment options have failed to provide sufficient relief. Historically, spinal cord stimulation was considered a last step therapy, but because of its great success in providing pain relief and avoiding the issues related to strong oral medications or frequent injection therapy, spinal cord stimulators are now considered to be indicated much earlier in the treatment course for chronic pain. Common conditions for which spinal cord stimulation may be used include:
- Lumbar or cervical spine pain, especially back pain that continues even after surgery (post-laminectomy syndrome)
- Post-surgical pain
- Spinal cord injuries
- Nerve-related pain, such as severe peripheral neuropathy and cancer-related neuropathy from radiation, surgery or chemotherapy
- Complex regional pain syndrome
- Phantom limb pain
- Visceral abdominal pain and chronic pelvic pain
Who should get a spinal cord stimulator?
As with all treatments, your Austin Pain Wellness doctor will make sure spinal cord stimulation is right for you — and that it is likely to provide significant relief from your chronic pain. To assist in making this recommendation, your pain specialist will likely order imaging tests and psychological screening to identify if any mental health conditions such as depression or anxiety are worsening your pain.
Let us know if you are interested in learning more about spinal cord stimulation, or schedule a consultation with one of our specialists now.