Spinal Cord Stimulation
Pain, especially back pain, can be excruciating and it can have detrimental effects on one’s mind, body, and soul. Many people with chronic pain experience symptoms of anxiety due to poor health. Spinal cord stimulators are there to fix that. Spinal cord stimulation (SCS) is a treatment that treats chronic pain primarily in the back, leg areas, and arm. This procedure uses electrical stimulation to block pain signals before reaching the brain. It involves moving special strings, called traces, to the spine and inserting them into an electrical stimulus inserted into your abdomen or buttocks.
Causes of Chronic Pain and need for Spinal cord stimulation
Chronic pain can occur for several reasons. Almost any nerve injury has the potential to become a chronic problem. Depending on the location of the traumatic event, this pain may be felt differently. Physical trauma, as well as other medical conditions or medications, can cause nerve damage. A pinched nerve in the back, uncontrolled diabetes, or a medical procedure are just a few of the things that can cause chronic pain. A person’s mental health can also play a role in recognizing pain and controlling it. Since there are many possible causes of chronic pain, the diagnosis and treatment of one chronic pain patient can differ from that of the same patient. It is important to understand that a person may have periods of almost constant pain associated with muscle or joint injury, arthritis, and many other medical conditions. Such pains, that are stubborn to go away and even harder to diagnose warrant the use of Spinal Cord Stimulator Surgery.
Spinal cord stimulation
Nerve signals are transmitted from the body to the brain regularly, keeping the body alert for any injury or damage. Sometimes nerves are damaged; they can send pain signals to the brain even if damage does not occur. Spinal cord stimulation is a treatment for pain that uses less electrical energy to block nerve impulses in the spine. It can be used to disrupt these signals so that the brain does not detect them. SCS transmits a small amount of electrical stimulation to the arteries in the spinal column, altering or blocking the nerve activity in a non-therapeutic function to reduce the sensation of pain reaching the brain.
Spinal Cord Stimulator Surgery
Spinal cord stimulation requires two procedures, that are testing and installing the device. Since some people may find it unpleasant and may not find relief from the pain completely, testing or trial can allow you to experience it for a while. If it does not work, the test strips can be removed, leaving no damage to the spine or arteries.
Spinal Cord Stimulator Trial
During this process, your surgeon will install a temporary device to test it. A temporary trial lead is placed in the spinal canal and it is connected with an external battery or cord stimulators. Guided by a type of X-ray called fluoroscopy, your surgeon will carefully insert the electrodes into the spinal cord. The area of your pain affects where these electrodes will be placed in the spine. Your surgeon may request your response during the electrode placement process. This test procedure requires only one cut on your back to place the electrodes. The generator or battery will be outside the body, usually a belt, and you will wear it around your waist. In about a week, you will examine how this device reduces your pain. The test is considered successful if you experience a 50% or greater reduction in pain level. If unsuccessful, the cords can be easily removed from the clinic without damage to the spine or nerves. If successful, the operation is scheduled to install the device permanently.
Implantation of Spinal Cord Stimulator
In the permanent spinal cord stimulator implantation process, the generator is placed under the skin, and the test electrodes are replaced with sterile electrodes. During the implantation procedure, electrodes will be held in place by sutures to reduce movement. The implant can take about one to two hours and is done as a medical procedure. After local anesthesia is provided, your surgeon will usually make one hole in your abdomen or lower back to hold the generator and another hole in your spine to insert the permanent electrodes. As a probationary procedure, fluoroscopy is used to determine where the electrodes are placed. Once the electrodes and generator are connected, and in operation, your surgeon will close the cut. Your surgeon may provide a lump to keep you relaxed and ask for your response during electrode placement.
How does Spinal cord stimulation work
Spinal cord stimulation disrupts the symptoms of pain that travel between the spine and the brain. Encouragement is brought about by a neurostimulator, a pacemaker-like tool embedded under the skin. The sensors travel from this device to the spinal cord through tiny cords called clues. After the procedure, you may have back pain, and you will not need to take as many painkillers. However, treatment does not cure back pain or cure the source of the pain. The stimulant can also be adjusted depending on your response to treatment. Stimulation does not eliminate the source of pain. It only changes the way the brain perceives. As a result, the amount of pain relief varies from person to person. SCS does not improve muscle strength. The goal of SCS is to reduce pain by 50 to 70%. However, even a little reduction in pain relief can be important if it helps you perform daily activities and reduces the amount of pain medication you are taking.
Conditions Treatable by Spinal Cord Stimulation
A physician may recommend Spinal cord stimulation therapy to treat chronic pain that has not responded to less invasive treatments, such as pain medications, physical therapy, and spinal injections. It is recommended for an increasing number of painful health problems. Treatment has the potential to reduce the pain associated with the following conditions in SCS candidate:
- Painful inflammation of the arachnoid, that is a thin layer covering the brain and spinal cord)
- Back pain, especially back pain that persists even after surgery (failed back surgery)
- A complex regional pain syndrome, a neurological condition that causes excruciating pain, usually in the arms, hands, legs, or feet
- Conditions including arthritis and spinal stenosis can cause chronic leg pain, called sciatica, or arm pain.
- Chronic pain in the spine due to spinal cord injury
- Heartache (angina) incurable by other treatments
- Vascular damage, neuropathy, and neuritis from damage to the outer sheathing or protective cover called myelin, of nerve cells, can cause burning pain, tingling sensations, and sensitivity to touch
- Nerve related pain like diabetes and neuropathy-related neuropathy, surgery, or chemotherapy
- Pain after amputation
- Peripheral neuropathy or peripheral vascular disease
- Chronic pain in the legs caused by distant nerves
- Visceral abdominal pain and perineal pain
Scenarios Where Spinal Stimulation is Not encouraged
SCS is considered successful if the pain reduces the pain by at least half, but not everyone achieves that goal. With traditional low-dose treatment, about 50- 60 percent of those who use spinal stimulation accomplish that goal. Still, studies have shown more than 80 percent experience relief from severe pain when using a new, more common treatment.
- A doctor may advise smokers to stop before starting treatment.
- Recreational drugs use is also considered to reduce the chances of successful treatment.
Spinal cord stimulation and nerve stimulation therapy are not for everyone. These treatments are generally not recommended for people:
- Have a reliable infection or infection in the incision sites
- Is depressed or have other attitudes that may be contributing to the pain
- Have bleeding problems that can be treated
- Have problems with untreated drug treatment
- Use the cardiac pacemaker
Post Spinal Cord Stimulator Surgery Recovery
Most patients are allowed on the day of treatment. For few days, the site of cuts can be painful. The dressing will be placed on top of the cutting areas, removed after three days. In most cases, cuts are cured within three weeks after surgery. When your surgeon allows, you can return to work. This usually takes one to two weeks after surgery. However, lifting, bending, and twisting should be limited to up to two months to allow the lead to heal in the right place without moving.
What to expect with spinal cord stimulator implant surgery?
After surgery, when you have a spinal cord stimulator, you are ready to begin a new chapter of a pain-free life. This procedure can improve the quality of life and sleep, and reduce the need for pain medication. However, your doctor will recommend pain medicines for the initial weeks to reduce pain and swelling around the implant site after surgery. You soon will become ready to return to your normal activities as you experience relief. However, recovery from the process of spinal regeneration requires patience and cooperation, and understanding. In the follow-up appointments, you will be guided to increase the level of your activities gradually. You can expect a little discomfort at the incision sites for at least 3 -7 days. When you heal your incisional pain, you will find that your chronic pain is also controlled. Most of the patients find this treatment smooth and effective. If you feel that this procedure can help you, then consult a specialist to see if the spinal cord stimulator is right for you.
Potential risks associated with SCS
Serious injuries or side effects are less likely to happen. The possible risks of this surgery include any of the following:
- Weakness or numbness below the inclination level
- Unwanted changes to the update, such as sending a stronger signal, stopping and starting, or sending a weak signal
- The stimulator may not work properly
- Pain after surgery at the implant site
- Moving or damaging a generator or track that requires additional surgery
- Skin erosion
- Infection of the battery or electrode area; if this happens, the hardware usually needs to be removed.
Living with Spinal Cord Stimulator
Usually, the pain relief provided by spinal cord stimulators allows patients to do much more than they would before surgery, but there are some limitations to keep in mind. The SCS device can interfere with other devices, such as pacemakers and defibrillators. After SCS is installed, you may not be able to get an MRI. As long as your spinal cord is turned off, X-rays and CT scans are usually safe. Before the test, tell your doctor, nurse, or specialist that you have a spinal stimulant. The security gates such as airport security gates can detect the stimulator, keep a diagnostic card that will allow you to skip the machine. If you can’t avoid passing through the security screen, you can turn off the device.
When & How to Seek Medical Care
Pain can negatively affect a patient’s life. Health care is recommended when pain interferes with a person’s normal activities and does not improve with rest. When the pain lasts for months, it can be considered long-term, and referrals to a pain specialist may be required.
In case your pain becomes persistent and unbearable due to any medical condition or injury, you should immediately seek medical care. If you are in Dallas Fortworth Area, Crescent Emergency Room provides such treatment options. Whatever the cause of your injury, regardless of the severity of your pain, experienced spine specialists at Crescent ER can assess your condition and help you determine the best course of action.