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Spinal Cord Stimulation

At A Glance

  • In spinal cord (or dorsal column) stimulation, a surgeon implants a device to control pain caused by various forms of nerve damage referred to as neuropathic pain.
  • Fifty to 70 percent of patients report good to excellent pain relief.
  • The idea is to trick the brain into perceiving the impulses from the stimulator and not from the damaged nerve(s), thereby eliminating the perception of pain.

 

The simplest explanation of this treatment is that it provides an electrical impulse directly to the lower part of the spinal cord in order to create the effect of covering up, drowning out or replacing painful nerve impulses traveling from the spinal cord and nerves to the brain.

With this treatment, 50 to 70 percent of patients report good to excellent pain relief, depending on underlying conditions.

Prior to trying the spinal cord stimulator as a treatment, a careful analysis of the patient’s pain type is essential. First, the patient should undergo a test called an EMG/nerve conduction study. In this procedure, a technician gently inserts needles into muscles in order to measure the speed of the body’s nerve signals.

Conditions that respond best to this treatment include:

  • Neuropathies – a collection of disorders resulting from damaged nerve endings
  • Post-traumatic neuritis – nerve pain after an injury, surgery, injections or other medical procedures
  • Regional pain syndrome – chronic pain after surgery, an injury, a stroke or heart attack
  • Herpetic neuralgia – pain, headaches and nerve problems resulting as complications from shingles, a type of virus caused by the chicken pox virus

 

Conditions that respond least include inflammation, pain from arthritis, acute trauma including fractures, pulled muscle, pinched nerves, spinal stenosis, and RSD (reflex sympathetic dystrophy) or Complex Pain Syndrome.

The device sending the stimulation – a dorsal column stimulator or spinal cord stimulator has two main components: a special catheter and a battery power electric pulse generator. It is commonly called an implantable TENS unit, an acronym for transcutaneous electrical nerve stimulation. (Transcutaneous refers to a procedure performed through the skin.)

A surgeon inserts the device typically in two stages. The first is the trial phase, generally performed under local anesthesia. This gives the patient the opportunity to try out the device for a week or more to determine if alleviates pain.

If successful, a surgeon implants a permanent device similar to a pacemaker under the skin, this time using general anesthesia. The patient uses a small external controller device about the size of a cell phone to program and operate the device.

 

Frequently Asked Questions

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