Overview of Spinal Cord Stimulation for Pain

Overview of Spinal Cord Stimulation for Pain

When suffering from chronic leg, back, and arm pain, you can seek relief from spinal cord stimulation and other similar therapies. Spinal cord stimulation therapy will mask your pain signals and stop them from reaching the brain. In this therapy, a pain management doctor will place a small device that ejects electrical pulses to your spinal cord.

Spinal Cord Stimulation and Working Mechanism

There are thin electrode wires in a spinal cord stimulator. It also includes a tiny battery pack that works as a generator. The doctor will place electrodes between the vertebrae and the spinal cord. They will insert the generator under the skin. A common location for placing a battery would be the abdomen or buttocks. Spinal cord stimulators generate electric pulses when you experience pain. You can control the device using a remote. The antenna and the remote control will remain outside the body.

Although experts are not entirely aware of how the spinal cord stimulation mechanism works, they find this technique effective. This machine targets different muscle groups through the spine and manipulates brain signals to eliminate painful sensations.

Traditionally, spinal cord stimulators induce mild tingling that replaces the sensation of pain. Experts refer to this technique as paresthesia. If you find these devices uncomfortable, you can choose new devices with sub-perception stimulation. Physicians receive training to place these devices inside the body with the guidance of ultrasound and X-ray.

How Spinal Cord Stimulation Helps

When non-surgical treatment options fail to reduce pain, spinal cord stimulation can be helpful. These devices provide sufficient relief to the body. You can use spinal cord stimulators to manage and treat various types of chronic pain, such as:

·       Post-surgical pain

·       Heart pain

·       Back pain or failed back surgery syndrome

·       Arachnoiditis

·       Complicated regional pain syndrome

·       Peripheral vascular disease

·       Injuries to the spinal cord

·       Nerve-related pain

·       Perineal pain and visceral abdominal pain

·       Pain after an amputation

You can improve sleep and quality of life with spinal cord stimulation, effectively reducing the need for pain medication. For better results, a pain management doctor will suggest you use this technique with treatments such as physical therapy, exercise, relaxation methods, and medication.

Why you Should Choose Spinal Cord Stimulation for Pain

Spinal cord stimulation therapy is different from other surgical procedures. This technique is reversible, and it means you can discontinue therapy whenever you want. After you decide to discontinue therapy, your surgeon will remove the wires, electrodes, and the generator from your body. There will be no permanent changes to your spine.

1.     Reduced Opioid Use

Your consumption of medication will drastically reduce after opting for peripheral nerve stimulation or spinal cord stimulation. Research shows that over a third of patients in the study stopped taking opioid medications. The participants suffered from chronic pain for 13 years on average (Source).

2.     Adjustable Pain Relief

The intensity of pain varies from one person to another. It is also possible that you experience different levels of pain at different times of the day. New and advanced spinal cord stimulation devices are adjustable depending on the severity of pain you experience. However, automatic devices change levels according to your movements. If you suffer from chronic pain, this feature will prove beneficial.

3.     No Side Effects

There are limited or no side effects of this device in contrast to medication.

4.     Cost-Effective Technique

Spinal cord stimulation is cost-effective compared to other non-surgical treatments for pain management.

5.     Minimally Invasive Procedures

This treatment does not induce any side effects as the surgeon will only make two incisions. One incision will help place the generator, while the other one for the electrode. Furthermore, the surgeon may also include electrodes with the help of hollow needles. 

Before Surgery

The pain management doctor will ask you various questions or fill forms, so they better understand the nature and intensity of the pain. The first thing your doctor might ask is the regions where you experience pain. Furthermore, the doctor might also suggest you keep a diary to note down the intensity and time that you experience pain in a specific part of the body. Finally, they will ask you to describe the pain in detail.

During Surgery

The surgery to introduce the spinal cord stimulation in your body will take one to two hours. Here are the steps that you will undergo during the surgery:

Step 1–Get yourself Ready

The doctor will ask you to lie down on the table, stomach-down. They will inject light anesthesia inside the region. Then, they prepare your buttocks and back to place the generator and the leads. 

Step 2 – Placing the Leads

The electrodes work as the lead. The doctor will use the aid of fluoroscopy to insert the lead inside the region. After making a small incision on the skin of your back, they will expose your bony vertebra. They will create a room by removing the bony arch. The doctor will then position the leads in the epidural space. After placing the electrodes, they will secure them with sutures.

Step 3 – Testing the Stimulation

You need to remain awake to direct doctors towards the specific pain point while the specialist will implant the device. However, this step depends on the spinal cord stimulation machine. If you are installing modern spinal cord stimulation device leads, the doctor will consider the monitoring of the nerves or anatomy. After the surgery, they will test the settings of the device and ask for feedback. This will ensure that the device is in the right position or not. If the implants are positioned perfectly, there would be no need to insert a new lead or reposition the old one.

Step 4 – Tunneling the Wire

After placing lead electrodes, they will place a wire under your skin. They will insert the wire till it reaches the buttocks. The specialist will insert a generator inside the buttocks.

Step 5 – Placing the Generator

To place the generator, your doctor will make a small incision below the waistline. This will give them a space to create the pocket for the generator under the skin. They will position the generator after connecting the lead wire to the pulse generator.

Step 6 – Closing the Incisions

With the help of skin glue and sutures, the surgeon will close the incisions. 

After the Surgery

After the procedure, the surgeon will transfer you into the recovery room until you wake up. They will ask you about the pain after monitoring your heart rate, blood pressure, and respiration. Depending on your condition, you might get discharged the same day. The doctor will program the generator before you leave. Here are some instructions that you should follow after reaching home. 

Restrictions

·       Avoid lifting, twisting, and bending for six weeks. The continuous movement will displace the lead from its position.

·       Do not drink alcohol. There are risks of blood thinning and bleeding due to alcohol. Also, avoid mixing pain medication with alcohol.

·       Avoid driving until your doctor gives you the all-clear.

·       Do not lift heavier than 5 pounds.

Incision Care

·       You need to wash your hands before and after the incision. This will prevent infection.

·       Do not apply ointment or lotion on the incision.

·       Avoid baths and diving into the pool.

·       Gently wash the area with skin glue every day. You can use soap and water for that. You need to pat the incision dry and avoid rubbing.

·       If you notice drainage from the incision, cover it immediately. Consult your doctor if the drainage persists after three dressings.

·       Pink and clear drainage is normal. However, if the drainage is colored or redness is spreading around the incision, visit your doctor as it can be a sign of an infection.

Conclusion

Many patients eliminate or reduce their consumption of pain medication after receiving spinal cord stimulation. Besides the stimulating device, your doctor may suggest various techniques to reduce the pain. These activities include exercise, medication, and different therapies. This technique is non-invasive and cost-effective compared to other pain management methods. Furthermore, spinal cord stimulation is a non-reversible method that does not cause any permanent changes to your body.