Spinal Cord Stimulation

Spinal Cord Stimulation Frequently Asked Questions

What is Spinal Cord Stimulation?

Spinal Cord Stimulation (SCS) is the stimulation of nerves by tiny electrical pulses. An implanted lead, which is powered by an implanted battery or receiver, is placed against the patient’s spinal cord. This system sends electrical pulses that block the pain messages to the patient’s brain. SCS implantation is a reversible procedure that does not damage your spinal cord or your nerves; however there are always risks involved with every procedure and surgery. Your doctors will go over all of the risks associated with SCS implantation prior to the trial and permanent surgeries.  Typically patients who have a successful SCS implantation experience 50-70% reduction in their pain.

What type of pain can be improved with SCS?

Intractable neuropathic pain is an indication for the use of SCS. Neuropathic pain is pain that is caused by actual damage to nerve tissue and is often felt as a burning pain or stabbing pain. It is often a chronic, unrelenting pain. This pain in normally accompanied with radiculopathy to the extremities, or pain traveling down the arms and legs.

What does the stimulation feel like?

Some patient’s describe the feeling of SCS as “tingling”. However, after the trial, if this feeling of tingling is annoying or disruptive to you, there are products available that do not have this feeling.

Am I a good candidate for SCS?

The best candidates for SCS implantation have severe chronic pain in their legs or arms. Patients with primarily leg or arm pain and mild back and neck pain can also benefit. In general, the wider the area of pain, the more difficult it is for SCS to be effective. Most patients who have tried more conservative therapies, but who have not experienced sufficient pain relief, are considered candidates for SCS therapy. The patient’s doctor often feels that surgery would not be beneficial.

How does my doctor choose what device is best for me?

At Oklahoma Pain Management, we use a variety of companies that offer different products based on a patient’s particular need. After your initial consultation, our doctors will discuss with you your options and together you can decide which device you would be most comfortable with.

What is the process of getting a permanent SCS?

First, you will have to get a psychological evaluation and then a trial spinal cord stimulator. This will give you the opportunity to try the device before a permanent implantation, to decide if you are comfortable with it and if it gives you the desired pain relief you are seeking.  After the trial you will then move on to the permanent implantation if you choose to do so.

Why do I have to have a psychological evaluation prior to surgery?

Most insurance companies require the psychological evaluation. Its purpose is to make certain that you have a realistic expectation about the implant and its ability to help manage your chronic pain. It is also useful to determine whether you have any related psychological conditions that may interfere with your ability to have a successful outcome.

How long will it take to schedule my surgery?

After a successful stimulator trial, we will work to get you scheduled for implant within 2 to 4 weeks. This will give your body time to heal from the trial period and also give us time to obtain insurance approval.

On average, how long does the surgery take?

The surgery itself takes one to two hours. You will need to arrive 1.5 hours before your appointment time. Most cases are done on an outpatient basis, which means you can usually go home two or three hours after surgery. If an overnight stay is required, you will be admitted under 24-hour observation status.

What are the risks associated with surgery?

Implanting an SCS has risks similar to spinal procedures, including but not limited to, spinal fluid leaks, headaches, swelling, bruising, bleeding, infection, and paralysis. A full list of risks will be explained to you when you meet with the doctor and again prior to the surgery. If you have questions or concerns about the risks, always ask your physician before moving forward with the surgery.

How big are the incisions?

There is a 2 to 3 inch incision along the spine that is used to place the lead in the spine. The incision for the stimulator (battery) is about 4 inches long. The lead wire is tunneled under the skin and connected to the stimulator.

After the implant, what precautions should I follow?

During the first 6 to 8 weeks following the surgery, you will need to avoid lifting, bending, reaching, and twisting movements. This allows time for scar tissue to form and anchor the lead.

What if my bandage needs changed after surgery?

We ask that you leave your initial bandage on until you come in for your post-op visit. Occasionally, the bandage will become soaked through with blood and in that case you may change it out with fresh gauze bandages. If it soaks through a second time, please notify the office.

When can I bathe and/or shower again?

You may sponge bathe 2 days after the surgery, but do not get the bandages wet. You may shower after 7 days after surgery, but do not get the bandages wet.

Is it normal to feel pain for weeks after the surgery? What can help?

You will probably experience pain for 2 to 6 weeks after surgery. This pain, caused by developing scar tissue, happens with any type of implant surgery. It is your body’s natural response to the implant. Once scar tissue forms, the pain will begin to diminish. Ice can help with pain and swelling at the affected areas. You may be given a prescription for pain medication after surgery.

How soon can I return to work?

If you have been working up until the time of your implant, you may be able to return to work within 2 weeks of your surgery. If your job involves any repetitive lifting, bending, twisting, or stooping, you may need to be off work for 6 weeks in order to avoid possible movement of the stimulator lead.

Can I go in a bath, hot tub, steam room or sauna?

Yes, after your incisions have healed. If you feel any localized heat sensation around your stimulator, you should get out of the tub or sauna room.

If I am having problems, when should I call the office?

If you are  having problems, or are concerned there may be a problem, you can always call our office to ask questions. However, there are times when you should call our office immediately.

  • If you are having excessive bleeding after surgery that soaks the bandage through after being changed
  • If you are experiencing excessive or unusual pain, swelling, or redness around your incisions.
  • If you are experiencing excessive or unusual pain, swelling, or redness around your incisions.
  • If you notice unusual changes in the quality or location of your stimulator, or when you experience no sensation at all.
  • If you are increasing stimulation more often than normal.
  • If you begin to run a fever

Schedule an appointment today to get relief for your chronic pain.