Chronic pain impacts every part of your life, and medications are often not the answer. One newer technology that is helping many patients is a spinal cord stimulator.
What is Spinal Cord Stimulation?
Spinal cord stimulation involves implanting a small device. The device has two parts; thin wires that are inserted into the epidural space, between the spinal cord and the surrounding vertebrae, and a battery pack implanted near the buttocks or abdomen. The battery pack is somewhat similar to those used in pacemakers.
The device sends electrical impulses directly to the spinal cord, which appears to affect how your brain perceives your pain by replacing it with other signals. The patient has a remote control that they can use to activate the implant when they feel pain. That is to say, it’s completely under the patient’s control and is used as much, and only as much, as needed.
Who is a Candidate for Spinal Cord Stimulation?
Spinal cord stimulation is recommended for patients with chronic pain in the back, legs, or arms that has not responded to physical therapy. It is also sometimes recommended for untreatable angina, nerve-related pain such as diabetic neuropathy, or phantom pain in amputees. The most common use is for failed back surgery syndrome, which is chronic pain that remains after surgery is performed. However, it is also often used as a less invasive alternative to surgery.
It is not recommended if you have epidural scarring from previous surgery, scoliosis (which can make it hard to properly place the electrodes), or severe spondylolisthesis. It is also not recommended for people who have demand-type cardiac pacemakers (as the two devices can interfere with each other), pregnant women, and people who operate certain equipment or machinery. Psychological screening is normal to ensure you understand how to use the device properly.
How is the Device Implanted?
The implantation procedure is simple and is generally done under sedation, not anesthesia. The incision sites are generally small. An X-ray is used to ensure correct placement of the leads. Generally this is an outpatient procedure that takes three to four hours. Female patients should wear a bra as this helps with placement.
Generally, you are released the same day, but should not stretch, twist or reach for several days so as not to pull at your incisions. Keep to lighter activity for about two weeks, and avoid driving. You will receive instruction on how and when to activate the device, which is intended, again, to be used as needed when you experience symptoms.
What Is it Like to Live with a Spinal Cord Stimulator?
In general, a spinal cord stimulator is not noticeable to others unless you are using the remote. However, it does result in some issues.
People with a spinal cord stimulator should not be given MRIs, and the device is known to set off airport metal detectors. Your doctor will give you a card to show security. Stimulators should be powered off if you are driving, operating heavy machinery, or otherwise can’t afford to be distracted.
Physical trauma such as a fall can cause the leads to shift and become ineffective. This requires a follow-up surgery to move them back. Your doctor may, thus, recommend avoiding activities that carry with them a high risk of falling.
You will continue to be monitored as the system may need to be recalibrated to stay effective. You will also need to return every few years to have the battery replaced. Some systems have rechargeable batteries which are recharged at night and last longer.
If you have chronic pain and physical therapy and other non-invasive methods are not working, you should talk to your doctor about spinal cord stimulation. It’s a less invasive and risky procedure than surgery and can allow you to manage your pain without drugs.