Announcing a solution when other traditional treatment plans for chronic pain–such as physical therapy, psychological interventions, nerve blocks, and surgery–haven’t worked.
Spinal cord stimulators (SCS) are medical devices that use a low-grade voltage to stimulate malfunctioning nerves and interfere with the erratic pain messages sent between the nerves and the brain. Spinal cord stimulation has been approved by the FDA and involves a minimally invasive procedure requiring a nerve stimulation device implantation.
Drs. Javier Placer and Ruben Rivera of the Florida Spine and Pain Institute are Board-Certified Interventional Pain Management physiatrists trained to perform this highly specialized procedure. If you suffer from chronic back or leg pain and are interested in learning more about the SCS procedure, continue reading.
How Do Spinal Cord Stimulators (SCS) Work?
While many pain management modalities are available, not all types of pain respond to them. Injections, medication, physical therapy, and surgery are all excellent ways to address many medical conditions, but certain types of pain may persist even after these treatments have been tried.
Some types of pain, like neuropathic pain, can be especially difficult to manage. SCS can be a helpful solution if you live with chronic pain that has not responded well to other treatments.
The process of spinal cord stimulator (SCS) implantation involves surgically implanting wire leads into the spine’s epidural space. These leads are connected to a small battery pack that keeps a low-grade electrical current flowing through them. The electrical stimulation from the leads interferes with the erratic pain messages sent between the nerves and the brain.
The electrical current flowing through the leads effectively “turns off” or “tricks” the nervous system, which can stop the brain’s perception of pain. This is similar to turning off a light switch or tricking the nervous system into blocking the pain signals sent to the brain.
The electrical stimulation is typically adjustable, allowing the patient to control the intensity and frequency of the stimulation to manage their pain.
What Conditions Respond Well to SCS?
Some of the conditions that commonly respond well to SCS include:
- Arachnoiditis: This is a condition that occurs when the protective layer around the spinal nerves becomes inflamed. SCS can help manage the pain associated with this condition.
- Chronic Regional Pain Syndrome (CRPS): CRPS is a progressive disease that is characterized by inflammation and pain in the affected area. SCS is often recommended for those with CRPS who do not respond well to other treatments.
- Failed Back Surgery: Those who continue to experience pain after back surgery may benefit from SCS. This condition is also referred to as Failed Back Surgery Syndrome.
- Neuropathy: Neuropathy is nerve damage that can cause pain, numbness, and tingling sensations. SCS can help manage the pain associated with neuropathy.
- Phantom Limb Pain: This is pain that occurs in a limb that has been amputated. SCS can help manage the pain signals the brain receives from the missing limb.
- Post-Laminectomy Syndrome: Post-laminectomy syndrome refers to chronic pain that persists after spinal surgery. SCS can help manage the pain associated with this condition.
- Reflex Sympathetic Dystrophy: RSD is a type of chronic pain that can occur after an illness or injury. SCS can be used to manage the pain associated with RSD.
While the FDA has approved SCS for the treatment of these conditions, it’s important to note that it may not be the best option for every patient. Each case is unique, and patients should discuss the potential benefits and risks of SCS with their healthcare provider to determine whether it is an appropriate treatment option for their specific condition.
SCS has become a popular treatment option due to its effectiveness in reducing pain levels. As more and more conditions are added to the list of those that respond well to SCS, it is likely that this treatment option will become even more popular in the future.
Conditions that May Disqualify You from SCS
While spinal cord stimulators (SCS) can be an effective treatment option for certain types of chronic pain, there are certain conditions that may disqualify a person from receiving SCS. Before undergoing SCS, patients should discuss their medical history with their healthcare provider to determine whether SCS is a safe and appropriate treatment option for their specific condition.
Some of the conditions that may disqualify a person from receiving SCS include:
- Untreated Bleeding Disorders
If a person has a bleeding disorder that is not being treated, the implantation of an SCS device may increase the risk of bleeding complications. Before undergoing SCS, a person with a bleeding disorder should discuss the potential risks with their healthcare provider.
- Heart Pacemakers
SCS can interfere with the function of heart pacemakers, particularly those that are demand-type pacemakers. A person with a heart pacemaker should discuss the potential risks and benefits of SCS with their healthcare provider.
While SCS can be an effective treatment option for chronic pain, it may not be effective for those with underlying depression. Depression can cause changes in brain chemistry that may interfere with the effectiveness of SCS.
- Mental Illness or Disability
Those with certain types of mental illness or disabilities may not be good candidates for SCS. Before undergoing SCS, a person with a mental illness or disability should discuss the potential risks and benefits with their healthcare provider.
- Drug or Alcohol Addiction
Those with drug or alcohol addiction may not be good candidates for SCS. Before undergoing SCS, a person with a history of drug or alcohol addiction should discuss the potential risks and benefits with their healthcare provider.
In addition to these conditions, smoking can also hinder the success of SCS. Smoking can cause changes in blood flow that may interfere with the effectiveness of SCS. For this reason, it is recommended that those who smoke quit before undergoing SCS.
It’s important to note that these conditions may not necessarily disqualify a person from receiving SCS. Each case is unique, and your healthcare provider will be able to provide personalized recommendations based on your medical history and current condition. Ultimately, the decision to undergo SCS should be made in consultation with a healthcare provider after carefully considering the benefits and potential risks.
SCS Trial Period
Before permanently implanting spinal cord stimulators (SCS), a temporary trial period is typically conducted to ensure that the device will be effective in managing your chronic pain. During the trial period, temporary leads are attached to an external power source worn on a belt for a week.
During this time, electrical currents target specific nerves to help manage the pain associated with a person’s chronic condition. A journal is kept during the trial period to track pain levels, and at least 50% pain relief is required for the successful permanent implantation of the device.
The temporary trial period is an important step in the SCS implantation process, as it allows the patient to determine whether the device effectively manages their pain. If the device is not effective, the leads can be removed, and the patient can explore alternative treatment options.
Once the trial period is complete and the patient has experienced sufficient pain relief, the SCS device can be permanently implanted.
The battery-powered generator may require replacement in 3-5 years, or a rechargeable generator that can be replenished without additional surgery may be used instead.
Spinal Cord Stimulation Available in Winter Park
If you have further questions about the SCS implant trial procedure, contact the Florida Spine and Pain Institute team.
Specializing in pain management and sports medicine, Drs Javier Placer is expertly trained to treat chronic and acute pain conditions. You don’t have to continue living with pain.
Schedule an online appointment with us today and get back to living the life you want.