While nobody’s exactly sure how it works, spinal cord stimulation has clinically proven that low levels of electrical energy, delivered straight to the nerve fibers in the spinal cord, can disrupt the signals that certain chronic pain conditions send to the brain, and replace them with a much more pleasant tingling sensation.
This procedure doesn’t eliminate the source of the pain. It only interferes with the pain signals and changes the way the brain perceives the pain signals.
What is a spinal cord stimulator?
A spinal cord stimulator is a specialized device that stimulates the spinal cord and spinal nerves by tiny electrical impulses via a small electrical wire placed behind and just outside the spinal cord in the epidural space. The electrical wire or lead contains a series of four to thirty two evenly spaced electrodes that can be programmed to generate an electrical field.
A small device implanted near the spine generates these pulses. The implanted generator used in spinal cord stimulation has similarities to a cardiac pacemaker, leading some to call the device a pacemaker for pain.
Spinal cord stimulation was first used to treat pain in 1967. Spinal cord stimulation was approved by the Food and Drug Administration (FDA) in 1989 to relieve pain from nerve damage in the trunk, arms, or legs, and now accounts for about 90 percent of all neuromodulation treatments.
The patient has full control over the device. A remote control is provided to turn the device on or off, up or down. Usually the device remains on 24/7, to ensure that pain is modulated at all times.
The device can replace pain sensations with a mild tingling called paresthesia. This is a pleasant sensation. Newer devices offer sub-perception stimulation to completely mask the pain, with no residual sensations. All types work with a remote control for the patient to manipulate the stimulation as required. Later models also have different waveforms for the electrical delivery – high frequency, high density, or burst stimulations.
What conditions may be helped by spinal cord stimulation?
- Complex regional pain syndrome (CRPS) / Reflex sympathetic dystrophy (RSD)
- Phantom limb pain
- Brachial plexus injury
- Failed Back surgery syndrome
- Post-Laminectomy Syndrome
- Post thoracotomy neuropathic pain
- Spinal Stenosis not operable
- Post Herpetic neuralgia
- Painful Diabetic neuropathy
- Spinal cord injury with paraplegia
- Occipital neuralgia
- Intercostal neuralgia
- Post hernia neuropathic pain
- Any other neuropathic pain
What are the benefits of spinal cord stimulation?
- It helps to reduce pain by interfering with pain signals.
- It helps patients with chronic pain perform their daily activities.
- It prevents taking opioids and other oral pain medications for a long period of time
- It is a better treatment for patients with chronic back pain, leg, or arm pain.
Is spinal cord stimulation safe?
Spinal cord stimulation is considered a safe procedure. A trial stimulation is first performed to know if you are a good candidate for the treatment and to check for any side effects. If there are any adverse reactions or side effects, the treatment will be immediately stopped.
How successful are spinal cord stimulators?
The success of spinal cord stimulation depends on the success of the trial stimulation. The treatment is considered successful if a patient experiences pain relief that is up to 50% or more.
Studies of spinal cord stimulation have shown good to excellent lasting pain relief in 50% to 80% of patients with chronic pain. Many patients have experienced significant improvements after undergoing the treatment and were able to return to their daily activities.