Back Pain Treatments: Spinal Cord Stimulation (SCS)

There are two types of implantable pain relief devices that are inserted near the spine to treat chronic and severe debilitating back pain: spinal cord stimulation devices and implanted drug infusion devices. Both types of devices involve a continuous delivery of treatment to the affected areas of the spine, or the spinal cord itself that are involved in causing the back pain. Both types of devices, as opposed to other delivery systems such as injections, involve the delivery of treatment at regular timed intervals.

Spinal Cord Stimulation: Since the 1960s, electricity has been recognized in the treatment of leg pain, back pain, and other pain symptoms such as numbness and burning. The theory behind electrical stimulation into damaged tissues is that this outside form of stimulation will decrease the perception pain by activating nerves other than the pain nerves that are sending the pain signals. These nerves that are newly activated send signals to the brain that compete with and/or block the pain signals causing some of your symptoms. If the other nerves are sufficiently stimulated, pain symptoms will be replaced with a pleasant tingling sensation.

Spinal cord stimulation (SCS) is delivered through a set of electrodes that are inserted into the epidural space. The electrodes are connected to and powered by a pulse generator that is surgically implanted into the upper buttock area of in the abdomen, near the affected vertebrae. The device is equipped with a pulse generator or radio receiver that delivers a small charge through the electrodes and into the epidural space to block or distract the body from experiencing pain.

Why it's done: SCS may be an alternative, or the only alternative, for patients who have not experienced significant pain relief for one to several other types of treatments. Typically, patients will have attempted oral medication therapies, traditional western back pain treatments such as physical therapy, and alternative treatments such as acupuncture or chiropractic before considering this type of therapy. Patients considered to be candidates for SCS will typically have unsuccessfully have attempted back surgery, and may be labeled with a condition known as failed back syndrome. The SCS device and procedure may be appropriate for patients that have not responded to one or several back surgeries, and who have persistent spine-related back or leg pain. The SCS device will not be involved in treating the underlying structural problem causing the pain, but it has been successful in improving the quality of life for many back pain sufferers.

How it's done: The implantation of this device is done in two stages, usually, with the first stage of the insertion of the system done in a surgical hospital setting. The first stage in involves the insertion of a temporary system that may be replaced with a permanent internal SCS device if the trial system proves successful. This first step involves placing a "trial" lead wire or dual set of wires into the epidural space, just like the wires would be placed in a permanent system. Unlike a permanent system, though, the electrode wires will be connected to an external device. The patient will go home with this temporary system and then consult with their doctor after a few days as to the level of pain reduction, if any, the patient experienced. If the patient reports significant benefits, he/she may have a permanent device introduced.