Spinal Cord Stimulation for Chronic Pain - A Comprehensive Guide

Spinal cord stimulation (SCS) is an advanced, minimally invasive treatment option for patients with chronic pain that has not responded to conservative care, injections, or even prior surgery.

Unlike medications or injections that target inflammation in a specific area, spinal cord stimulation works by changing how pain signals are transmitted through the spinal cord. For carefully selected patients, it can provide long-lasting relief from otherwise debilitating nerve-related pain.

At Groth Pain and Spine, spinal cord stimulation is considered when standard interventional treatments have been exhausted, and pain continues to affect a patient's quality of life. 

What Is Spinal Cord Stimulation?

Spinal cord stimulation includes the placement of small, thin electrodes in the epidural space of the spine. These electrodes cause mild electrical impulses that modify pain signals before they reach the brain. The system consists of -

• Small epidural leads placed near the spinal cord 

• A pulse generator (battery pack) implanted under your skin 

• A handheld remote that allows patients to adjust settings 

The goal is not to eliminate all sensation, but to replace or reduce painful signals with a more tolerable sensation, often described as tingling or paresthesia (though newer systems may be “paresthesia-free”).

How Does Spinal Cord Stimulation Work?

Pain signals travel from your body through peripheral nerves to the spinal cord and then up to your brain. In chronic pain conditions, these signals can become amplified or abnormal.

Spinal cord stimulation works by -

• Interrupting or modifying pain signal transmission 

• “Masking” pain signals with mild electrical stimulation 

• Modulating the dorsal column pathways in the spinal cord 

• Reducing central sensitization over time 

This does not fix the underlying structural problem but can significantly reduce the brain’s perception of pain.

Call 631-543-1440 to Schedule an Evaluation 

Conditions Treated with Spinal Cord Stimulation

Spinal cord stimulation is most effective for neuropathic and nerve-related pain conditions, including -

1. Failed Back Surgery Syndrome (FBSS)

Persistent pain after lumbar spine surgery is one of the most common indications for SCS.

2. Chronic Radicular Pain

Ongoing sciatica or cervical radicular pain that has not responded to injections or surgery.

3. Complex Regional Pain Syndrome (CRPS)

A severe pain condition involving abnormal nerve signaling, often after injury or surgery.

4. Peripheral Neuropathy

In selected cases, including diabetic neuropathy.

5. Chronic Post-Surgical Pain

Pain following procedures such as a laminectomy or discectomy.

Who Is a Good Candidate?

Spinal cord stimulation is usually considered when -

• Pain has persisted for more than 6 months 

• Conservative treatments have failed 

• Injections have provided only temporary or inadequate relief 

• Surgery is not indicated or has already failed 

• Pain is primarily neuropathic (burning, shooting, electric pain) 

The most suitable candidates often have - 

• Predominant leg pain rather than isolated back pain 

• Clear functional impairment 

• Realistic expectations about outcomes 

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The Spinal Cord Stimulation Trial

Before permanent implantation, patients undergo a trial period, which is one of the most important steps in determining success.

Trial Process

• Temporary leads are placed through a needle into the epidural space 

• These leads are connected to an external pulse generator 

• The trial usually lasts 7 days 

• Patients track pain relief, function, and activity levels \

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What defines a successful trial?

• At least 50% reduction in pain 

• Improved ability to perform daily activities 

• Reduced need for pain medications 

If the trial is successful, doctors usually implant a permanent system. 

What Does a Permanent Implant Procedure Include?

If the trial provides good results, doctors implant a permanent spinal cord stimulation system during an outpatient procedure. 

Step-By-Step

1. Lead Placement 

   The doctor places permanent epidural leads under fluoroscopic guidance. 

2. Pulse Generator Placement 

   The doctor implants a small battery under the skin, usually in the buttock or abdomen.  

3. Programming 

   The device helps optimize pain relief efficiently

Doctors usually perform the procedure under sedation or anesthesia, and most patients tolerate it well. 

What Does Spinal Cord Stimulation Feel Like?

Older systems produced a tingling sensation known as paresthesia. But newer technologies provide -

• No perceived sensation at all (sub-perception therapy) 

• Gentle tingling or buzzing in earlier-generation systems 

• Adjustable stimulation patterns as per patient preference 

Patients are able to control settings using a handheld remote.

Call 631-543-1440 to Discuss Chronic Nerve Pain Treatment 

How Effective Is Spinal Cord Stimulation?

Effectiveness depends on proper patient selection. But some studies and clinical experience show -

• Significant pain reduction in well-selected patients 

• Improved function and mobility 

• Reduced reliance on opioid medications 

• Improved quality of life 

It is not a cure. But it can meaningfully reduce chronic pain burden in patients with otherwise limited options.

What are the Risks and Considerations?

As with any implantable device, there are potential risks, including -

• Infection 

• Lead migration or displacement 

• Hardware malfunction 

• Pain at the implant site 

• Incomplete pain relief 

Most complications are manageable, and many can be corrected without removing the entire system.

How Long Does it Take to Recover After the Implantation?

Recovery usually involves -

• Limited activity for 1 to 2 weeks 

• Avoiding bending, twisting, and heavy lifting initially 

• Slow return to normal activity 

• Follow-up programming adjustments 

Most patients resume their normal daily activities within a few weeks.

Spinal Cord Stimulation vs. Other Treatments

Pain specialists may recommend SCS when other treatments no longer provide enough relief -

Compared to Injections

• Injections can provide temporary relief 

• SCS is best for long-term symptom control 

Compared to Surgery

• Surgery helps in correcting structural problems 

• SCS is an option for ongoing nerve pain when surgery is unlikely to help. 

Compared to Medications

• Reduces reliance on long-term medication use 

• Avoids systemic side effects 

When Should You Consider SCS?

Spinal cord stimulation can be appropriate if -

• You have chronic nerve-related pain 

• You have not improved with injections or therapy 

• Surgery has failed or is not an option 

• Pain continues to limit daily life despite treatment

What Patients Ask About Spinal Cord Stimulation

 

1. Can I travel with a spinal cord stimulator?

Yes. Most patients can travel normally after recovery. You may need to carry information about your device when passing through airport security, and your doctor can provide guidance before you travel.

2. Will I be able to adjust my spinal cord stimulator settings?

   
   

Yes. Most spinal cord stimulation systems include a handheld remote that allows you to adjust settings within approved ranges to help manage your pain more comfortably.

3. How long does the battery in a spinal cord stimulator last?

Battery life depends on the type of device and how often it is used. Some batteries may last several years. But rechargeable systems can often last even longer with proper maintenance.

Takeaway

Spinal cord stimulation is an advanced, evidence-based therapy for chronic neuropathic pain that has not responded to conventional treatments. By directly modifying pain signals in the spinal cord, SCS can reduce pain and improve the quality of life in patients. 

If you suffer from persistent nerve pain that has not responded to other treatments, spinal cord stimulation may be a valuable option to consider. At Groth Pain and Spine, we carefully evaluate each patient and use a trial system to ensure the highest likelihood of success before permanent implantation.

Get Personalized Pain Treatment at Groth Pain & Spine 

If your chronic nerve pain has not improved with medications, injections, or surgery, spinal cord stimulation can be a good option for you. At Groth Pain & Spine, we carefully evaluate each patient and use a trial period to determine if SCS is the right treatment.

Led by Dr. Timothy Groth, a board-certified pain management specialist with more than 20 years of experience, our team provides personalized care, same-day appointments, and advanced treatment options. We accept most major insurance plans, as well as Workers' Compensation and No-Fault cases. 

You can call 631-543-1440 to schedule an appointment.