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SPINAL CORD STIMULATION

Spinal Cord Stimulation (SCS), also called epidural nerve stimulation (ENS), is a minimally-invasive procedure with a 40-year track record of delivering proven relief to patients experiencing chronic pain.

SPINAL CORD STIMULATION QUICK FACTS:

  • Spinal cord stimulation is often used as a treatment after nonsurgical pain treatment options have failed to provide sufficient relief. In addition, it is used after a failed back surgery.
     

  • Spinal cord stimulators require two procedures to test and implant the device: the trial and the implantation.
     

  • Spinal cord stimulation can improve overall quality of life and sleep, and reduce the need for pain medicines.

What is Spinal Cord Stimulation and How Does It Work?

 

To fully understand one of the most exciting breakthroughs in chronic pain therapy in decades, we have to begin with what seems, at first, to be a very basic question:

 

What is pain?

 

You might be thinking, well that’s easy, pain is when it hurts. That’s essentially true. But why is it hurting? By answering this question, we arrive at why a modern breakthrough in the decades-old technique of Spinal Cord Stimulation is such a transformational opportunity for patients suffering from chronic pain.  It may be an option if you suffer chronic back, leg or arm pain and have not found relief with other therapies.

So, what is pain?

 

Pain is the process of your brain perceiving and interpreting sensations the body is experiencing. These signals are transmitted via nerve pathways to the brain, where they are interpreted through a very complex process that is influenced by multiple ancillary factors. 

 

What many people realize, but don’t give too much thought to, is that pain is inherently subjective. This means that different people experience pain in very different ways, even if the conditions causing the pain are very similar. In addition, physical pain has a significant impact on your mental and emotional health. Chronic pain can impact many aspects of your life, putting a strain on relationships, limiting recreational activities, altering sleep schedules, influencing your mood, your outlook, and your approach to daily living. 

 

What is Chronic Pain?

 

For pain to be considered “chronic” the pain fits into one or all of the following criteria:

 

  • Pain that persists for several months, usually at least three, despite treatment

  • Pain that resists natural coping efforts

  • Pain that may be caused by injury or infection, where the cause has healed but the pain remains

  • Lingering pain that causes emotional distress, including anger, anxiety, and depression

 

According to multiple studies, about 8 percent of the adult population of the United States suffers from chronic neuropathic pain. For the majority of people, this manifests as lower back pain, which can have a strong, persistent negative effect on a person’s quality of life. 

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What is Spinal Cord Stimulation?

 

Spinal cord stimulation was developed in the 1970s as a therapeutic treatment for pain in the back, trunk, or limbs. A spinal cord stimulator is an implanted device that sends low levels of electricity directly into the spinal cord to relieve pain. The therapy creates signals to block pain signals from reaching the brain. This is achieved by either wearing or implanting a small battery and very thin lead wires which deliver therapeutic energy to the area affected by the pain, relieving or replacing the pain signals with a more pleasant sensation. 

Who is a Candidate for a Spinal Cord Stimulator?
 

  • Spinal cord stimulators may be used to treat or manage different types of chronic pain, including:

  • Back pain, especially back pain that continues even after surgery (failed back surgery syndrome)

  • Chronic leg (sciatica) or arm pain: ongoing, persistent pain caused by arthritis or spinal stenosis

  • Failed back surgery or post-surgical pain – pain following one or more surgeries to relieve persistent arm, leg pain, or back pain

  • Nerve-related pain (neuropathy)

  • Complex regional pain syndrome - patient’s symptoms can include chronic burning pain, typically in the foot or hand.

  • Arachnoiditis - inflammation and possibly scar tissue around the scarring the protective lining of the spinal nerves which can cause chronic pain.

  • Cervical and lumbar radiculitis

  • Chronic neck pain with or without arm pain

Advantages of Spinal Cord Stimulation:

  • Adjustable pain relief. Pain varies widely from person to person, as well as within a person at different times with different movements. Patients are able to adjust the treatment with a hand-held controller or with Bluetooth technology that can be used today by their cellular phones.

  • Minimally invasive procedure. There is typically just one incision needed to implant the Spinal Cord Stimulator. Then the leads are done with a needle, as opposed to additional incisions. The Spinal Cord Stimulator has few side effects and is easily reversible.

  • Reduced opioid use. For one that is reliant on pain medication, the spinal cord stimulator provides relief which often reduces if not eliminates medication. Studies have shown that more than a third of one patient’s having SCS therapy reduced or stopped taking opioid medications.

  • Targeted pain relief. Instead of taking a medication that affects the whole body and causes sleepiness, constipation, or other problems unrelated to the pain, spinal cord stimulation delivers pain relief only where it is needed.

  • Cost-effective pain relief. Researchers have found that the costs associated with spinal cord stimulation compare favorably with alternatives, including non-surgical treatments.,

  • Less medical treatments. Pain relief with a spinal cord stimulator lasts for years without the need for frequent office visits or prescription refills.
     

Facts about Spinal Cord Stimulation (SCS):
 

  • The U.S. Food and Drug Administration has approved or cleared SCS systems for the management of chronic pain.

  • It is covered by many major health insurance plans, Medicare, and workers' compensation programs.

  • You can have a short temporary evaluation (Trial Placement) performed to see if SCS works for you.
     

What is a spinal cord stimulator comprised of?
 

  1. Neurostimulator device (small computer) sits under the skin and controls the electrical current.

  2. Electrode which sits near the spine

  3. Internal wire which connects the computer to the electrode

  4. A Remote control or your cellular phone to adjust the strength of the electrical current or turn it on or off.

 

Test Drive a Spinal Cord Stimulator:

 

One of the most popular benefits of spinal cord stimulation is the option patients have to try the treatment out before opting for the long-term, implantable solution. After a consultation with their pain doctor, if the patient is a good candidate for spinal cord stimulation, they will wear a temporary version of the treatment system for about a week. 

 

The test phase begins when the doctor places thin wires, called leads, into the skin using a simple needle stick. These wires deliver low-energy pulses to interrupt the pain signals to the brain. The leads are connected to a small external battery, which is worn outside the body, typically on the lower back. Patients control their therapy with a remote control, adjusting the therapeutic pulse as needed.

 

The goal of the five-to-seven-day trial is to determine how well the spinal cord stimulation therapy helps the patient manage their pain. Patients may be a good candidate for the longer-term implant solution if the temporary system:

 

  • Provides meaningful pain relief

  • Improves the ability to perform daily activities

  • Allows for better sleep

 

If the patient experiences one or more of these benefits, their physician may suggest the longer-term SCS solution. 

 

Permanent Spinal Cord Stimulator Recovery - Long-Term Pain Relief

 

If the patient receives relief and elects to and is approved for the longer-term solution, the next step is to have a spinal cord stimulator implanted. Patients have this procedure done in Windward Surgery Center; our out-patient facility adjacent to our practice. Patients return home after their procedure, once the anesthesia has worn off. For a few days after surgery, one may have some discomfort from your incisions. Incisions heal within about 2-4 weeks after surgery, and we generally recommend lighter activity for about 2 weeks after surgery.

 

After this short recovery period, usually only a few weeks, most patients are able to return to their normal daily activities, free of chronic pain.

 

Patients with Spinal Cord Stimulators have reported:

  • A 50% or greater reduction in pain

  • A reduction or elimination in the use of pain medications

  • Increased activity levels and an improved overall quality of life

 

Today the Breakthrough Technology of a Spinal Cord Revolutionizes the Way We Can Treat Pain:

 

While some physicians still use technology that replaces pain signals with the “pleasant tingling sensation,” there are newer, better options available that block the pain without replacing it. This means that the patient feels nothing from the stimulator, and they feel significantly diminished or no pain. 

Today, as of 2021, the options on the market that we offer provide relief from both physical pain and emotional grief that is often associated with chronic pain. This cutting-edge technology is carefully optimized, mimicking the natural patterns which are generated from the brain. It is remarkable how this new device can actually continue to be effective, even after a patient turns the stimulation off. We can now provide comfort, convenience and a highly effective long-term pain treatment to our patients.

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For people living with chronic pain and movement disorders, Abbot provides treatments that help patients move and feel better.

 

The following documentation has been provided by Abbott regarding spinal cord stimulators and how they can help patients achieve pain relief and get back to living a full life. Please click on the images below to view the various brochures.