Chronic back pain develops when the body’s appropriate response to an injury lasts longer than it should. Once the pain starts, it can interfere with work, exercise, eating, or a variety of other daily activities. Over time, back pain can cause other chronic health problems like depression, anxiety, and weight gain. Some patients even experience issues related to medication overuse to manage the discomfort.
Nerve signals are transmitted constantly from the body to the brain. This process helps prevent injury by making the person aware that something is wrong. When nerves are damaged, they can send pain signals to the brain even if an injury is not occurring. Spinal cord stimulation (SCS) blocks the brain from receiving those important signals.
Please note, this article is for informational purposes only. If you are experiencing chronic back pain, speak with a medical professional before planning your next steps.
What is a Spinal Cord Simulator?
As a newer treatment alternative for chronic back and neck pain, a spinal cord stimulator is a small medical device, much like a pacemaker, that utilizes electrical impulses to mask pain signals before they reach the brain.
The device is implanted in the body through a needle placed in the back near the spinal cord. A small incision is then made to place the pulse generator (battery) under the skin in the upper buttock.
Once activated, the stimulator sends electrical signals to the leads to mask pain signals. The patient has the ability to turn the current off and on or adjust the intensity of the signals.
What Spine-Related Problems are Treatable with SCS?
Determining if you are a candidate for a spinal cord stimulator will mainly depend on what’s causing the pain. Spinal cord stimulation (SCS) is widely accepted treatment option for patients experiencing neuropathic pain caused by a pinched or injured nerve.
Additionally, any patient with mechanical back pain caused by these conditions may be an ideal candidate for SCS:
- Degenerative disc disease
- Radiculopathy (pain that radiates down an arm or leg)
- Spinal stenosis (narrowing of the spinal canal)
- Failed back surgery or residual pain following back surgery
Spinal cord stimulation can also successfully treat these medical conditions:
- Complex Regional Pain Syndrome (CRPS)
- Multiple Sclerosis (MS)
Note: SCS is not recommended for the treatment of numbness or weakness nor is it useful for treating pain resulting from a bone fracture or cancer.
When Should a Trial of SCS Be Considered in a Person with Chronic Pain?
Spinal cord stimulation is recommended for patients with chronic pain that has persisted for over 3 months and has failed to resolve with other treatments like physical therapy, injections, and medication management.
SCS is also suggested for situations when surgery is not likely to help, or when surgery has already failed. For example, patients with chronic neck pain who have undergone a failed cervical spine surgery may benefit from using a spinal cord stimulator. Several recent studies have also shown that patients with axial low back pain with or without leg pain may find pain relief by using a spinal cord stimulator.
In specific cases, such as patients with CRPS, it is recommended SCS be used even sooner because the success rates drop significantly if pain persists for longer than a year. That’s because the pain pathways become rewired in people with CRPS for more than one or two years, making it more difficult to reverse the condition.
However, each patient should undergo an SCS trial before implanting the device to ensure that the treatment provides them with pain relief.
What if the trial fails?
Unfortunately, patients desperate for relief may still request SCS implantation even if they have responded poorly during the trial. Anytime the SCS trial is unsuccessful, the device should not be implanted. In those cases, other pain management treatments should be offered instead.
What Types of Physicians Use SCS in the Treatment of Chronic Back and Neck Pain?
SCS is most often used by pain management physicians such as anesthesiologists, orthopedic surgeons, neurosurgeons, and physiatrists. Additionally, SCS is increasingly being used by neurologists for other conditions like occipital neuralgia (a form of severe headache), cardiovascular surgeons for intercostal neuralgia (rib pain following surgery), and general surgeons to treat nerve pain from hernias.
What Advice Do You Give Patients About Selecting a Physician Who is Knowledgeable About SCS?
If you are a candidate, your best bet is to choose a doctor that has accumulated a great deal of clinical experience with SCS. In the chronic pain management field, experienced physicians are those that have treated 20 or more patients with SCS. In addition, suitable patient selection and expectations are just as important.
What Questions Should Patients Ask Their Physician When Considering Treatment with SCS?
Before agreeing to SCS treatment, be sure to ask your physician these questions first:
Are there any structural problems with my spine that should be addressed first?
- Sometimes, pain doctors refer patients for SCS when they have an underlying mechanical problem that an operation might correct.
What is your clinical experience with SCS?
- Try to work with a physician that has done 20 or more SCS procedures. Even better, find one who is currently involved in the research and development of spinal cord stimulation devices!
Are all spinal cord stimulators the same?
- Thanks to over three decades of clinical experience, more advanced spinal cord stimulator models are now available. A traditional stimulator uses tonic stimulation, where the patient might feel a tingling sensation much like a light massage in the area where they formerly felt pain. Burst stimulation and high-frequency stimulation are newer SCS forms that provide pain relief differently. Your doctor should present the various spinal cord stimulator types and discuss which options are right for you.
What are the symptoms of spinal cord stimulator rejection?
If your body rejects the stimulator, you may experience symptoms that include:
- A shooting pain in your legs and arms
- Severe headaches
- Tailbone discomfort
- Poor bladder control
- Muscle weakness
- An electric shock sensation
- A localized infection or abscess near the incision site.
Are there any permanent restrictions with a spinal cord stimulator?
- SCS is contraindicated for anyone with a heart defibrillator. SCS patients must not operate a motor vehicle while their spinal cord stimulator is on. And finally, some older SCS systems may not be compatible with MRIs, although CT scans are okay.
How long will a spinal cord stimulator last?
- Studies suggest that spinal cord stimulators relieve pain for up to 20 years, although the neurotransmitter’s battery does have an expiration date. Most batteries are rechargeable and can be recharged by holding a charger over the neurostimulator implanted under the skin.
Your Experienced Spine Care Specialists in Chicago
At The Spine Center, we’re dedicated to providing you with high-quality, personalized back and neck care. We strive to offer efficient and professional services to our patients, delivered with integrity and honesty in a state-of-the-art, family-like environment. We have a solid commitment to excellence in diagnosing and treating spinal injuries and conditions spanning all age groups.
As fellowship-trained physicians with over 50 years of experience treating spinal conditions, we offer patient recommendations for treatment, including conservative care, non-operative treatment, and sophisticated, customized surgical solutions. Our physicians serve as innovators in technology, actively participate in national and international research studies, and are at the forefront of medical knowledge. If you or a loved one is suffering from back or neck pain, call The Spine Center today at (847) 628-8147 to schedule a consultation.