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Gray haired woman

Spinal Cord Stimulation: An Option for Chronic Pain

Jun 11, 2020 |
By Landon Tyler Burns, MD
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There are many reasons a person can be in pain. For most people, this pain will improve with time or limited medical treatment. There are cases however, in which the pain does not improve and is called “chronic.’’ 

How to manage chronic pain

There are many ways to manage chronic pain. Some ways of treating pain are noninvasive, such as physical and occupational therapy or medications, or invasive options, such as injections and surgery, which are the most commonly used methods. These methods can usually achieve manageable levels of pain. For people who have chronic pain that does not respond adequately to these methods, spinal cord stimulation may be a good option.

Spinal cord simulation

A spinal cord stimulator is an implantable device that sends small electrical signals to your spinal cord to block pain signals from reaching your brain. These devices utilize wires, called “leads,’’ that are safely inserted into the epidural space near the spinal cord, and a battery that generates the electrical stimulus. The process is broken down into two parts, a “trial” and an “implant.’’ These steps are both done on an outpatient basis and the patient returns home the same day. Patients undergoing these procedures usually receive some form of sedation and are therefore very comfortable. Spinal cord stimulators are very effective for nerve pain that moves down one or both legs and can help some with lower back pain. Spinal cord stimulation is also effective for diabetic peripheral neuropathy, failed back surgery syndrome and complex regional pain syndrome.

Spinal cord stimulation uses different types of technology such as low frequency and high frequency settings. The low frequency sensation allows for the pain signals to be decreased and provides a pleasant tingling sensation that is felt by the patient. High frequency settings would provide pain relief with no tingling sensations. Most current spinal cord stimulation companies provide both high and low frequency options and some devices offer both.

The first part, called a “trial,’’ is temporary and fully reversible. It is done using only needles and does not involve any incisions or stitches. The leads exit the body through the skin and are connected to an external battery. The purpose of the trial is to make sure that a patient gets an adequate amount of relief before undergoing a permanent implant. The trial lasts for a few days, during which the patient works with a representative of the device manufacturer to optimize the device settings to get the maximum amount of relief. At the end of the trial period, the patient returns to the doctor’s office to discuss the effects of the device and to have the trial leads removed. Removing the trial leads is usually painless. If the patient had very significant relief during the trial period, then they can choose if they wish to have the device permanently implanted.

The second part, called an “implant,’’ is very similar to the trial, but does require some incisions. The implant is intended to be permanent. After the implant is complete, both the leads and the battery are completely beneath the skin. Initially, there are some activity restrictions to allow for the incisions to heal and to prevent the leads from moving out of place. After a period of time, the incisions should be healed and the leads should be scarred down and less likely to move. After this period, the patient should be able to enjoy their usual activities with decreased pain.

Schedule an appointment with Dr. Landon Tyler Burns

Tags
spine care
pain management

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