Spinal Cord Stimulation or Neuromodulation
Treatment of chronic pain using Spinal Cord Stimulation (SCS) is on the forefront of interventional pain management techniques. Spinal cord stimulation uses low voltage stimulation of the spinal nerves to block the feeling of pain. It helps you to better manage your pain and potentially decrease the amount of pain medication. It may be an option if you have long-term (chronic) leg or arm pain, and have not found relief through traditional methods. A small battery-powered generator implanted in the body transmits an electrical current to your spinal cord. The result is a tingling sensation instead of pain. By interrupting pain signals, the procedure has shown success in returning some people to a more active lifestyle.
What is a spinal cord stimulator?
A spinal cord stimulator (SCS), also known as a dorsal column stimulator, is a device surgically placed under your skin to send a mild electric current to your spinal cord (Fig. 1). A small wire carries the current from a pulse generator to the nerve fibers of the spinal cord. When turned on, the stimulation feels like a mild tingling in the area where pain is felt. Your pain is reduced because the electrical current interrupts the pain signal from reaching your brain.
Patients selected for this procedure usually have had a disability for more than 12 months and have pain in their lower back and leg (sciatica). They’ve typically had one or more failed spinal surgeries.
You may be a candidate for SCS if you meet the following criteria:
- Conservative therapies have failed
- Your source of pain has been verified
- You would not benefit from additional surgery
- You are not seriously dependent on pain medication or other drugs
- You do not have depression or other psychiatric conditions that contribute to your pain
- You have no medical conditions that would keep you from undergoing implantation
- You have had a successful trial stimulation
An SCS can help lessen chronic pain caused by:
- Chronic leg (sciatica) or arm pain: ongoing, persistent pain caused by degenerative conditions like arthritis or spinal stenosis, or from nerve damage.
- Failed back surgery syndrome: failure of one or more surgeries to control persistent leg pain (sciatica), but not technical failure of the original procedure.
- Complex regional pain syndrome (CRPS): a progressive disease of the nervous system in which patients feel constant chronic burning pain, typically in the foot or the hand. Formerly called reflex sympathetic dystrophy (RSD).
- Arachnoiditis: painful inflammation and scarring of the meninges (protective layers) of the spinal nerves.
- Other: stump pain, angina, peripheral vascular disease, multiple sclerosis, spinal cord injury.
If your pain is caused by a correctable condition, then this must be fixed first. You cannot have a Spinal Cord Stimulator if you have a cardiac pacemaker.