Learning About Spinal Cord Stimulation

What is it?

Spinal cord stimulation is a treatment for chronic pain. It uses a mild electrical current. It's mostly used for low back pain, pain in the arms and legs, and pain in the trunk.

A small generator is placed in your body. It sends electrical pulses to a tiny electrode near your spinal cord. You may feel a tingle from the pulses. The pulses can help relieve pain.

Why is it done?

This treatment may be done for people with severe, chronic pain who have:

• Had back surgery that didn't help their pain.
• Pain from a nerve problem.
• Pain that does not respond to other treatments. This includes complex regional pain syndrome.
• Pain from severe peripheral vascular disease that the doctor feels cannot be treated with surgery.

If this treatment is right for you, you may have a spinal cord stimulator implanted for long-term use.

How is it done?

Spinal cord stimulation is done in two steps. Your doctor will first insert a temporary electrode through your skin. It will stay there for about a week. This first step is to see if the treatment will help your pain.

You and your doctor will test different stimulation settings and programs. Your doctor will ask you how you feel at different settings. Let your doctor know if you feel any discomfort.

You'll use a wireless remote control or other controller.

If the test works, you may get a permanent stimulator. The electrode is implanted in your spine. A lead wire runs from your spine to a small generator. It can be under the skin in your lower or upper back, buttock area, chest, or belly area.

You may get medicine that relaxes you or puts you in a light sleep. Some people may need to have general anesthesia. The areas being worked on will be numb.

After the stimulator is placed, your doctor will show you how to care for the areas where you had surgery.

What are the different types of spinal cord stimulators?

This treatment targets the area of your body where you feel pain. There are different types of devices you may get.

• The devices can have different power sources.
  • Some generators have batteries that need to be replaced every 3 to 5 years. Some last longer.
  • Some have rechargeable batteries. A special wireless charger may come with your system. These last much longer. But they still may need to be replaced at some point.
  • Some stimulators may have a power source outside your body. These are more often for short-term use.
• The leads that carry the electrical current can be placed at different spots along the spinal cord.
• You will have a controller to program the device. Your doctor will show you how to use it.

What can you expect after getting a spinal cord stimulator?

You may have a spinal cord stimulator for many years. It can help you live with much less pain, but you will have to learn how to use it.

After the surgery, you and your doctor can figure out the best pulse strength. It may need to be adjusted a few times. Your doctor will show you how to use the stimulator at home.

You may feel a tingle or some warmth while you use electrical nerve stimulation.

Your doctor will show you how to be safe with a stimulator. This may include trying not to lift, bend, stretch, or twist too much. Being too active could move or disconnect the leads. Light exercise, such as walking, is good.

After a few weeks, you will be able to move more. You may get important instructions on driving and air travel, as well.

Your device may set off metal detectors. And anti-theft devices in stores can cause a burst of stimulation.

Be sure to tell other doctors about your stimulator before you have any other procedures or scans. Some scans and procedures can cause serious problems with your device.

What are the risks?

There are some risks to spinal cord stimulation. For example:

• Placing the stimulator requires surgery. Surgery has risks, such as the risk of bleeding, infection, or fluid buildup at the surgical site. Anesthesia also has some risks.
• The stimulator device and wires can fail. The wires may also move, so the stimulator doesn't work as well as it should.
• The tingling or warm feeling from the electrical current may bother you. You may need the device removed if it bothers you too much.
• If you build up a tolerance to the stimulation, your doctor may need to change the amount of current or placement of the wires.
• Your pain may come back, and the device may no longer work for you.