Welcome to
Ask
About
Pain
Your Pain is Our Concern
Chronic pain not caused by cancer is among the most common and debilitating medical conditions in the United States, but also among the most controversial and complex to manage. Beyond physical symptoms, chronic pain can negatively impact a person’s relationships, ability to work and be productive, perform the tasks of daily living, and enjoy their life. Chronic pain is also associated with higher rates of depression, anxiety, and suicidal thoughts and attempts compared to those without chronic pain.
Many chronic pain patients will have tried a variety of treatment strategies to reduce/control their experience of pain, including opioids. Unfortunately, inappropriate use and over-prescribing of opioids to treat chronic pain has resulted in a national epidemic highlighted by numerous deaths and countless numbers of reported addictions. If you are seeking non-opioid alternatives to treating chronic pain, then, we’re here to help. We're the North American Neuromodulation Society (NANS), representing pain physicians performing neuromodulation in the United States.
A Non-Addictive Treatment Option
Spinal cord stimulation (SCS), a form of neuromodulation, is different because it’s not a medication nor invasive surgery. Instead, it is a long available, proven safe and effective, non-addictive treatment option for chronic pain. Though many different SCS implantable devices are available, they all work by stimulating the spinal cord, a nerve or set of nerves using controlled electrical impulses to alleviate pain. Unique to this kind of therapy, patients can "trial run" the device recommended by their physician to better understand what to expect from the permanent procedure. Plus, one advantage of SCS is that patients can take the lead in controlling their pain by using a remote control to turn their SCS on or off, select different therapeutic programs, or control the stimulation personalized to their needs.
Many chronic pain patients will have tried a variety of treatment strategies to reduce/control their experience of pain, including opioids. Unfortunately, inappropriate use and over-prescribing of opioids to treat chronic pain has resulted in a national epidemic highlighted by numerous deaths and countless numbers of reported addictions. If you are seeking non-opioid alternatives to treating chronic pain, then, we’re here to help. We're the North American Neuromodulation Society (NANS), representing pain physicians performing neurmodulation in the United States.
Find a Physician
Use the NANS Find a Physician search to find doctors that are NANS members and specialize in neuromodulation therapies
Spinal Cord Stimulation
Learn more about spinal cord stimulation devices.
Risks and Benefits of SCS: As with any surgery, there are risks associated with implanting these devices. Complications from SCS may include painful stimulation, loss of pain relief and certain surgical risks (e.g., infection). Be sure to discuss the risks and benefits of neurostimulation with your doctor.
Spinal Cord Stimulation
SCS was developed for the treatment of neuropathic (nerve) pain. This pain is typically associated with injury to nerves or metabolic problems such as diabetes and is described by patients as burning, shooting, or tingling. Nerve pain typically does not respond well to narcotic pain medications. When it was first used in patients, SCS was more or less restricted to the treatment of pain of the arms or legs. Recent advances in technology have made it more useful for the management of neuropathic pain in other areas of the body, such as in the back, neck, or pelvis. Neurostimulation covers up or masks the pain by interfering with the pain sensation going up to the brain without interrupting with other sensations.
SCS: The Trial Period
The trial period for SCS is very important. It allows the healthcare provider and the patient to confirm that he or she will respond to therapy. Performed on an out-patient basis, during the trial, electrode leads (wires) are temporarily placed into the spine through a needle without any cutting, but the generator — a device similar to a pacemaker that transmits the electric current — remains outside (to sit in a back pocket, for example). A patient is also given a remote control to manage their stimulation within prescribed ranges. A local anesthetic is injected in the skin prior to placing the needle to manage pain from the placement of the wires advanced into the spine. The trial usually lasts 4-7 days and during that time the patient will be asked to assess how they feel during different times of the day or doing certain activities.
SCS: Implantation
Following a successful trial, a specialist will insert the permanent device in an out-patient procedure (lasting 30-90 minutes), sometimes with sedation or general anesthesia. In a numbed area, the electrode lead is surgically implanted into the epidural space in the spine. Then, the generator or receiver is connected to the electrode lead and is surgically implanted nearby, usually in the upper buttock/back, upper chest wall, or abdominal wall area. During the procedure, the patient may be awakened for pain level feedback so that small adjustments can be made to ensure the stimulation is targeting the areas where pain is transmitted to provide optimal pain relief. Following the implantation, patients learn to use the handheld stimulator controller that turns the energy level up and down similar to a television remote controller to adjust the stimulation level.
SCS: Recovery
Even though SCS implantation is considered a minimally invasive procedure, patients should expect a pain recovery up to several days with a period of restriction of movement of several weeks. During that time, patients need to avoid activities that might jostle the carefully placed leads, such as stretching, bending, lifting or other extreme movements of the torso. On the other hand, light exercise is recommended to rebuild strength and endurance, for example, walking. Your doctor will tell you what to expect from SCS surgery and recovery, plus provide information on your specific device’s operation and battery life.
