Pain Management: Spinal Cord Stimulation



Spinal Cord Stimulation for Back Pain Relief

Tried everything for back pain, but you just can't find relief? This last-resort treatment can actually trick your brain and block pain signals.

By Marie Suszynski

Medically Reviewed by Pat F. Bass III, MD, MPH

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When your back pain doesn't go away with the usual treatment measures and it starts affecting your quality of life, it may be time to consider another option: spinal cord stimulation.

Spinal cord stimulation uses a low-voltage electrical current on the spinal cord to relieve pain.

This technique might be one to consider when you haven't found back pain relief from medications, physical therapy, injections, and even back surgery, says Alon Mogilner, MD, PhD, section chief of functional and restorative neurosurgery at the Cushing Neuroscience Institutes of the North Shore-LIJ Health System in Manhasset, N.Y.

Spinal Cord Stimulation for Back Pain Relief

As a back pain treatment, spinal cord stimulation rewires your nervous system to replace pain signals with a different type of signal. Instead of pain, you'll feel a small vibration that confuses the pain signal, says Ferhan Asghar, MD, spine specialist and assistant professor of orthopedic surgery at the University of Cincinnati College of Medicine in Ohio.

The vibration doesn't hurt and the system doesn't shock you. It's more like a pleasant, tingling sensation. Think of what happens when you jam your thumb and automatically rub it to make it feel better, Dr. Mogilner says. The rubbing sends a different kind of signal to your brain that makes you feel more comfortable.

Spinal cord stimulation involves placing electrodes close to the spinal cord and connecting them to a permanent device similar to a heart pacemaker that's implanted over your hip. You'll have a battery pack that controls the amount of stimulation your spinal cord receives.

There are two types of systems your doctor may implant. One is rechargeable, which means you'll have to wear a recharging belt every two weeks for an hour, but overall it lasts about nine years without needing to be replaced.

The other type of system is nonrechargable. There is no recharging the device — it simply needs to be replaced in two to six years, Mogilner says.

If your doctor recommends spinal cord stimulation, you'll probably start with a trial in which a needle is placed near your spine in an outpatient procedure and works the same way an implant would. Experiencing pain relief after using it for up to a week is a good indication that spinal cord stimulation will work for you as a back pain treatment.

Good Candidates for Spinal Cord Stimulation

You have to meet certain criteria to qualify for spinal cord stimulation. It's not an alternative to surgery — it's not a primary back pain treatment for a problem like a pinched nerve for instance, Dr. Asghar says.

But if you've had surgery and didn't get back pain relief or if you have a damaged nerve, you may be a good candidate.

Risks and Benefits of Spinal Cord Stimulation

Any type of surgery comes with risks and benefits. Here's what to consider if your doctor suggests going with this procedure:

The risks:

  • There's a small risk of infection and nerve damage, but these risks are lower than they are for standard spinal surgery, Mogilner says.
  • With most of the devices available, you won't be able to have magnetic resonance imaging test (MRI) in the future, but you can have other tests such as a diagnostic ultrasound, Mogilner says.
  • If you are very thin, you may have some discomfort with the generator over the hip, Asghar says.
  • The electrodes near the spinal cord can also cause some rib discomfort, but fixing it is a matter of reprogramming the system to avoid stimulating those nerves, Asghar says.

The benefits:

  • Although it's rare for someone to be 100 percent pain-free after the procedure, spinal cord stimulation can make you feel dramatically better — usually at least 50 percent better.
  • With chronic back pain under control, people see a huge improvement in their quality of life.





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Date: 06.12.2018, 20:30 / Views: 33584