What is spinal cord stimulation?

Spinal cord stimulation is a therapy that treats chronic pain of the back, legs and arms. Spinal cord stimulation uses electrical pulses to block pain signals before they reach the brain. It involves passing special wires, called leads, into the spine and attaching them to an electrical stimulation device implanted in your abdomen or buttocks. 

Spinal cord stimulation is only one method used to treat chronic pain. Discuss all of your treatment options with your doctor to understand which options are right for you. 

Why is spinal cord stimulation performed? 

Your doctor may recommend spinal cord stimulation to treat chronic pain that has not responded to less invasive treatments, such as medications, physical therapy, and spinal injection. Spinal cord stimulation treats chronic pain from the following conditions:

  • Arachnoiditis, which is inflammation of a lining that surrounds and protects the brain and spinal cord. Arachnoiditis can cause spasms, muscle cramps, and stinging and burning pain in the lower back or legs. 
  • Degenerative conditions including arthritis and spinal stenosis, which can cause chronic leg pain, called sciatica, or arm pain
  • Complex regional pain syndrome, which is a nerve disorder that causes burning pain, usually in the arms, hands, legs or feet 
  • Failed back surgery syndrome and post-laminectomy syndrome, which is persistent or recurrent lower back or leg pain following spinal surgery 
  • Nerve damage, neuropathy, and neuritis from damage to the outer sheathing or protective covering, called myelin, of nerve cells that can cause burning pain, pricking sensations, and sensitivity to touch

Who performs spinal cord stimulation?

A neurosurgeon implants a spinal cord stimulation device and manages the device after implantation. Neurosurgeons specialize in the medical and surgical care of people with diseases and conditions of the brain and nervous system.

How is spinal cord stimulation implantation performed?

Your spinal cord stimulation implantation will be performed in a hospital or clinic. 

Spinal cord stimulation involves two phases. The first phase is a temporary trial procedure to see if spinal cord stimulation effectively relieves your pain. The trial procedure also helps your surgeon determine what type of therapy and stimulation settings are best for you. The second phase involves implanting a permanent spinal cord stimulator. 

The trial procedure generally involves these steps: 

  1. You will remove your clothing, all jewelry, and accessories and dress in a patient gown.
  2. Your care team will give you a light sedative to relax you. Sometimes your team will use general anesthesia to put you in a deep sleep.
  3. Your surgeon will clean your lower back and inject a local anesthetic under the skin to numb the area.
  4. Your surgeon will make a small incision in your lower back or insert a special needle into the space around your spinal cord, called the epidural space. 
  5. Your surgeon will insert one or more wires, called leads, into the epidural space through the needle or incision.
  6. Your surgeon will ask you questions about your pain to help determine the best placement of the leads. You will be awake during this part of the procedure.
  7. Your surgeon connects the leads to a temporary stimulator device that you wear on a belt for about a week. The device produces electrical pulses and sends them through the leads into your spinal cord to block pain signals from reaching the brain. 
  8. Your team will close the incision and apply a dressing.
  9. Your care team will teach you how to program your spinal cord stimulator for optimal pain relief before you go home.

If the trial spinal cord stimulation is successful, your surgeon will implant permanent leads using a similar procedure. Sometimes general anesthesia is necessary for the permanent implantation procedure. Your surgeon makes a small incision in your buttocks or abdomen to implant a permanent stimulator device under the skin. 

Will I feel pain?