Spinal Cord Stimulation for Chronic Pain

Spinal Cord Stimulation for Chronic Pain

Hi, I’m Dr. Tann Nichols. I am a neurosurgeon with Mayfield Brain & Spine. I would like to talk to you about spinal cord stimulators, an important treatment option for people who suffer from chronic pain. So before we talk about treatment options we need to make sure we are all on the same page. Chronic pain is defined as pain that has lasted
for more than 3 months. That is not a long period of time. You don’t need to suffer for years and years
to fit this definition. Research shows that people with chronic pain
do better when they are treated earlier rather than after suffering for a prolonged period
of time. This is true whether we are talking about
spinal cord stimulators or other more conventional procedures. If you have suffered debilitating pain of
the spine, arms or legs for 3 months or more, you might be a candidate for a spinal cord
stimulator. It works best for nerve pain, but it also
can help people who suffer from arthritis, spinal stenosis and other degenerative problems. Generally, spinal cord stimulation is reserved
for people who did not improve following more structural surgeries or who are not candidates
for these procedures. A spinal cord stimulator is a system that
includes a pacemaker-like device that delivers mild electrical impulses to the spinal cord
via wires, or leads. The electrical impulses interrupt pain signals
and prevent them from reaching the brain. Spinal cord stimulators have been used in
the treatment of chronic pain since the 1960s, and they are continually being updated and
improved to optimize patient experience and outcomes. I tell patients that getting a spinal cord
stimulator is like reupholstering your sofa. The sofa looks better and feels more comfortable,
but I won’t go jumping on it. The analogy is that you feel better with the
stimulator, but it’s not changing your spine in any way. One of the best features of spinal cord stimulation
is that you can try it out first before undergoing surgery. It’s like taking a new car home for a test
drive for a few days. The trial procedure lets us know whether the
stimulator is likely to be effective for you. If the trial procedure reduces your pain,
you can be pretty confident the permanent implant will as well. During the stimulator trial, we insert a small
wire into the epidural space around the spinal cord. It is attached at the other end to a battery
unit that can be hooked to your belt or clothing like a pager. You go home after your appointment and see
whether you like it. Some SCS devices use a low-frequency current
to replace the pain sensation with a mild tingling feeling called paresthesia. Other SCS devices use high-frequency or burst
pulses to mask the pain with no tingling feeling. A paresthesia-free setting is an option on
most devices. After three to five days, we remove the wire
in the office and, with your input, we make a decision: Do we implant the system permanently,
or do we try other therapeutic options? If you choose to have the stimulator system
implanted, we schedule you for the procedure, which we do in an outpatient setting so that
you go home the same day. During the last 10 years I have implanted
spinal cord stimulators in more than 350 patients. Clearly, spinal cord stimulators are a time-tested
option for people who feel they have exhausted their other options or feel they have reached
the end of the road with their pain. People who have had multiple injections or
back surgeries and are still suffering should know that spinal cord stimulators can make
a significant improvement in their life. If you take pain medication, the stimulator
typically enables you to take less. This means an improvement in side-effects. With less medication, people are able to be
more functional, more engaged with their families, and more able to enjoy life. If you have questions about spinal cord stimulators,
or if you think you might be a candidate for one, please visit us at MayfieldClinic.com

2 comments on “Spinal Cord Stimulation for Chronic Pain

  1. Daniel Ortego Post author

    Good information so thanks for posting. Currently I'm waiting for my appointment with the doctor to proceed with the initial step. Hopefully it won't take long because I seldom sleep through the night. In fact, I average about two hours sleep and that's it. Popping pain pills, pain patches, surgery, and epidural injections have all have failed. This is pretty much the last resort, so I remain hopeful.


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