How Does a Spinal Cord Stimulator Work? A Patient’s Complete Guide

January 27, 2025

Spinal cord stimulators provide excellent pain relief. Studies show 47% of patients experience over 50% reduction in pain, while only 12% get similar results from repeat surgery. These devices serve as a middle ground between injection therapy and major surgery for chronic pain management.

Many patients ask about these innovative devices. The spinal cord stimulator blocks pain signals through controlled electrical pulses near the spinal cord. This provides relief around the clock. The outpatient procedure takes just 1-2 hours and reduces dependence on pain medications by a lot.

This detailed guide will help you understand spinal cord stimulators better. You’ll learn how they work, who qualifies for treatment, what daily life with the device looks like, and what results you can expect.

Understanding Spinal Cord Stimulation Basics

A spinal cord stimulator helps manage chronic pain by sending mild electrical pulses near the spinal cord. These pulses block pain signals before they reach the brain [1].

The science behind spinal cord stimulation comes from the gate control theory of pain. The electrical stimulation activates larger nerve fibers that “close the gate” on smaller pain-carrying nerve fibers. This prevents pain signals from reaching your brain [1].

The therapy has shown great results. Studies indicate that 50-70% of patients see their pain levels drop by half [1].

These are the conditions we commonly treat with spinal cord stimulation:

  • Failed back surgery syndrome
  • Complex regional pain syndrome (CRPS)
  • Chronic neuropathic pain
  • Diabetic neuropathy
  • Arachnoiditis
  • Heart pain (angina)
  • Post-surgical pain [2]

The stimulation system works with three key parts:

  1. Electrodes or leads: Thin wires placed in your spine’s epidural space deliver electrical pulses
  2. Implantable pulse generator (IPG): A battery-powered device creates the electrical signals
  3. Remote control system: You can adjust settings and control the device with this [1]

We use two types of stimulation patterns. Traditional stimulators replace pain with a light tingling sensation called paresthesia. The newer devices offer “sub-perception” stimulation that you won’t feel [2]. The battery can last up to 10 years, depending on how you use it [1].

The Journey to Getting a Spinal Stimulator

We assess each patient’s suitability for spinal cord stimulation carefully. You might be a good candidate if you meet these key criteria:

  • Have experienced chronic pain for at least 6 months [3]
  • Have tried other treatments without success
  • Show no signs of substance use disorder [4]
  • Have received clearance from a mental health professional [4]
  • Maintain realistic expectations about pain relief

Spinal cord stimulation works best for conditions like failed back surgery syndrome, complex regional pain syndrome, and chronic neuropathic pain [4].

Your treatment starts with a trial period that lasts 5-8 days [5]. We place temporary leads near your spine using a special needle during this phase. This procedure takes about 30-90 minutes [6] and happens in our office or an outpatient surgery center.

You’ll control the stimulation with an external device throughout the trial. This “test drive” helps determine if the therapy manages your pain effectively. The trial succeeds when you experience at least 50% pain reduction [3].

Let’s discuss the costs. Most insurance providers, including Medicare, cover spinal cord stimulation [7]. Coverage depends on meeting specific criteria, such as:

  • Documented chronic pain lasting over 6 months
  • Previous unsuccessful treatment attempts
  • A successful trial period showing major pain reduction [3]

Out-of-pocket costs can range from $15,000 to $50,000 [7] for uninsured patients. Many healthcare providers offer financial support plans to make treatment available.

Living with Your Nerve Pain Stimulator

Living with a nerve pain stimulator needs some adjustments, but patients adapt quickly to their new normal. Let me explain everything in daily life with your device.

Daily activities and limitations

You’ll need to watch out for certain activities. Our patients should avoid:

  • Heavy lifting, twisting, or excessive bending
  • High-impact sports or activities
  • Activities with fall risks
  • Scuba diving below 10 meters [8]

You should turn off your stimulator when driving or operating heavy machinery [2]. Airport security requires special attention – ask for a manual pat-down and show your medical ID card instead of walking through security gates [2].

Battery management and charging

Charging your stimulator will become part of your routine. Your usage patterns and settings determine how often you’ll need to charge. Some patients charge weekly, while others need to charge every other day [9].

You’ll soon find the best charging schedule that fits your lifestyle. Here’s what you should know about charging:

  • A full charge takes 45 minutes to several hours [9]
  • Higher stimulation settings drain the battery faster [9]
  • Don’t charge while sleeping to avoid burns [10]

Using your stimulator controller

Your remote controller lets you manage your pain effectively. You can adjust stimulation levels based on what you’re doing and how you feel [11]. Without doubt, you’ll like knowing how to modify settings throughout your day.

X-rays and CT scans are usually safe with the device turned off [2]. But MRI scans need special attention – some newer devices work with MRIs, though this depends on your model [2].

Managing Expectations and Results

My experience as a pain management specialist has taught me to set realistic expectations about spinal cord stimulation outcomes. Our target remains a 50% reduction in pain with these implants [12].

Typical pain relief outcomes

Our data reveals that 88.2% of patients report overall improvement after three years [1]. Several patients achieve complete pain relief and reduce or eliminate their pain medications. Each patient’s success varies, and we call it effective treatment when pain reduces by half or more.

Potential challenges and solutions

Spinal cord stimulator complications affect about 2-3% of procedures [12]. Common challenges include:

  • Inadequate pain relief
  • Device-related infections
  • Lead migration or malfunction
  • Battery issues
  • Gradual decrease in effectiveness

Device removal rates stand at 3.5% annually, with just 1.1% due to inadequate pain relief [1]. Patient screening and detailed guidance on device care help minimize these risks.

Long-term maintenance requirements

Most patients use their stimulator for two to three years before needing changes [12]. Long-term care includes:

  1. Regular check-ups to monitor device performance
  2. Battery management based on usage patterns
  3. Periodic adjustments to stimulation settings
  4. Monitoring the implant site for signs of infection

Settings adjustments or lead repositioning often restore optimal pain relief if effectiveness decreases. Recent devices with multiple waveform options show lower explant rates [1].

Conclusion

Spinal cord stimulation has emerged as a game-changing solution for chronic pain management. This treatment gives new hope to patients when other options haven’t worked. The results speak for themselves – most patients see their pain cut in half, and many need fewer pain medications.

Living with a stimulator means making a few lifestyle adjustments. These changes are minimal compared to the freedom of moving better and feeling less pain. The sort of thing I love about this treatment is its trial period. Patients can test it out before they make their final decision.

The numbers tell an impressive story. Nearly 90% of patients still report better quality of life even three years later. Simple maintenance and regular check-ups keep the device working at its best throughout its life.

Wondering if spinal cord stimulation could help you? Let’s talk about your options. Our team’s steadfast dedication to proper screening, realistic goals, and ongoing care helps patients take back control from chronic pain. Schedule a visit with us today and learn more about this life-changing treatment.

References

  1. https://www.tandfonline.com/doi/full/10.2217/pmt-2022-0091
  2. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/treating-pain-with-spinal-cord-stimulators
  3. https://www.nevrohfx.com/learn/article/how-much-does-a-spinal-cord-stimulator-cost/
  4. https://www.aetna.com/cpb/medical/data/100_199/0194.html
  5. https://www.excelpainandspine.com/treatments/spinal-cord-stimulator-trial
  6. https://www.medtronic.com/uk-en/patients/treatments-therapies/spinal-cord-stimulation-chronic-pain/therapy-overview/spinal-cord-stimulator-trial.html
  7. https://floridasurgeryconsultants.com/spinal-cord-stimulator-surgery-everything-you-should-know/
  8. https://www.spine-health.com/treatment/pain-management/disadvantages-and-risks-spinal-cord-stimulation
  9. https://www.spine-health.com/treatment/pain-management/recharging-rechargeable-scs
  10. https://www.bostonscientific.com/en-US/patients-caregivers/device-support/scs/system-charging.html
  11. https://www.bostonscientific.com/en-US/patients-caregivers/device-support/scs/using-remote.html
  12. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/spinal-cord-stimulator-removal-qa
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