Spinal cord stimulation (SCS) is a novel technology that addresses some of the most difficult back related pain problems experienced. Proven as an effective treatment option for many chronic pain sufferers, SCS is most often used for neuropathic pain, including diabetic neuropathy, radiculopathies and complex regional pain syndrome. If you suffer from chronic neuropathic pain, spinal cord stimulation may enable you to control and relieve your pain. Board-certified Pain Specialists at Virginia Spine Institute can determine if this is an appropriate option for you to help improve your life.
Neuropathic pain occurs when there is an injury, disease, or trauma to the central nervous system (spinal cord) or peripheral nervous system (nerves outside the spinal column). Symptoms of neuropathic pain can feel like sharp pain, pricking, burning, and even painful numbness. You may experience a high degree of pain from something as simple as a light touch or a brush against the skin. You may also feel an increased response to a painful stimulus.
Spinal cord stimulation provides pain relief by using an implanted device that transmits mild electrical impulses to the spinal cord. This stimulation interrupts the perception of pain, substituting it with a more pleasing sensation called paresthesia. This feeling can differ from patient to patient, but is often described as a pleasant tingling.
At Virginia Spine Institute, we begin with a temporary percutaneous trial to confirm a successful response. When SCS is introduced on a trial basis, a temporary lead is placed to determine if the therapy provides satisfactory pain relief. It's an important step to find out if you are comfortable with the sensations of spinal stimulation. The stimulation trial requires relatively little time and is performed on an outpatient basis in a sterile office setting. A local anesthetic is used to numb the area before one or more leads are placed in the epidural space along the spinal cord. These soft, thin wires with electrical leads on their tips are placed using a thin needle. When the leads are positioned in the best location, they are connected to a portable, external generator. Once connected, the system generates mild electrical pulses that will be programmed to replace your areas of intense pain with the more pleasing paresthesia.
Your doctor will determine the length of the trial period. It may last for a few days or at most, one week. The trial allows you to test how well you respond to stimulation throughout the day. At home, you can determine how well the stimulation helps control your pain during your daily routine and how it impacts your ability to engage in different activities. You should take notes to keep track of how the stimulation covers your pain, so you can share this information with your doctor who will be closely monitoring your progress. You and your doctor will decide if the trial was successful and if you will benefit from SCS.
After this determination, your doctor will work with you to schedule the placement of a permanent SCS system. It's important to know that SCS allows you to be in control. Using a magnetic remote control, you can turn the current on and off or adjust the intensity, thus allowing you to rapidly respond to changes in the severity of your pain. Since the system is portable, SCS makes it possible to resume many normal daily life activities at home and at work, as well as recreational activities, such as swimming, traveling, biking, and gardening. SCS also enables many people to reduce or eliminate the use of pain medications. Keep in mind that even though an SCS system is called permanent, it is a reversible therapy. If treatment should no longer be needed, the implanted parts can be easily removed.
The trial procedure takes approximately 30 to 45 minutes, and is followed by a short period of observed recovery. The procedure to implant the long-term device is performed by a surgeon in an outpatient surgical setting, and generally takes about two hours.
SCS can be an effective way to decrease the severity of chronic pain to a more manageable level. There are many clinical studies supporting the effectiveness of SCS therapy. While the degree of pain relief varies from person to person, studies show that 85 to 90% of those who have undergone treatment report a 50 to 70% reduction in overall pain. Many also report a significant increase in their ability to enjoy normal family and work activities again. We know that reducing pain can have a positive effect on your mental outlook, reduce stress, and improve overall quality of life.
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