If you have pain following back surgery, your doctor might recommend physical therapy, medication or injections. But what if these pain-control options aren’t giving you the relief you need to tackle your daily activities?
Spinal cord stimulation could be the answer. Robert Bina, MD, a neurosurgeon with Banner Brain & Spine, explained that spinal cord stimulation is a therapy that grew out of experiments in the 1960s. “We essentially confuse the brain’s pain system by applying mild electrical currents on the spinal cord. The brain interprets these signals and cancels out the painful feelings,” he said. “It’s an old technique—we have nearly 60 years of data and research, and we still aren’t 100% certain why it works.”
What happens with spinal cord stimulation
A small device placed in your back emits mild electrical currents to part of the spinal cord. This area contains fibers that sense vibration and position. The electrical currents confuse the brain. “Essentially, they tell the brain that everything is okay and that the pain it thinks it is feeling isn’t real,” Dr. Bina said.
Types of pain spinal cord stimulation can treat
The treatment works best on neuropathic pain, which is pain due to damage to nerves. People often describe this type of pain as burning or tingling pain. Some people notice numbness as well. It’s most frequently used for people with pain after spinal surgery who aren’t good candidates for spinal fusion surgery.
It might also be used to treat:
- Other types of back pain or post-surgical pain
- Facial pain
- Heart pain that doesn’t respond to other treatments
- Peripheral vascular disease pain
- Pain from diabetic neuropathy
- Pain from spinal cord injuries
- Pain following cancer treatments
- Pain from inflammation of the membrane that covers the brain and spinal cord
Getting a spinal cord stimulator implanted
Spinal cord stimulation doesn’t work for everyone, so the first step is a trial. Dr. Bina said, “Before implanting a device, we have to know it might help. When it works, it can work very well, so a trial is worthwhile.” For the trial, you’ll usually see a physician who specializes in pain management.
“Placement of a spinal cord stimulator does not guarantee that it will alleviate all of a patient’s pain,” Dr. Bina said. The trial is considered successful if you have a 50% or better reduction in pain, which is the case for about 50% of people. If you meet that threshold, you can have a device implanted permanently.
In most cases, a pain management physician can perform the procedure in an outpatient surgery center. Sometimes, though, previous surgeries or other medical conditions make the insertion more complex. A neurosurgeon might place the devices in those cases, and you may need to go to a hospital.
During the procedure, first, your surgeon makes an incision in the middle of your back. Then they remove some bone to create space and place the paddle with the electrical contacts on top of the spinal cord. The paddle is connected to a battery that’s placed under the skin and the device is turned on. Then your surgeon closes the incision. Most people go home on the day of surgery and are back to their normal activities within a week or two.
The future of spinal cord stimulation
The device isn’t just used for treating pain. It’s helping people who have had spinal cord injuries walk again, and it is being researched and studied in clinical trials for various conditions, including chest pain, bowel motility issues and others.
The bottom line
Spinal cord stimulation works by sending a small electrical current to the spinal cord, which triggers the brain to ignore the pain it thinks you’re feeling. It doesn’t work for everyone, but it can be a good pain relief option for certain people whose pain doesn’t respond to other treatments.
Need help treating chronic pain?
Schedule an appointment with a pain medicine specialist.