Spinal cord stimulation has been a successful treatment within the realm of electrodiagnostic medicine for quite some time. The best part about it is that you get to “test drive” an external version of the device to ensure that this is the proper treatment for you.
Listed below are some common questions we often get asked about spinal cord stimulator trials, along with our answers. Click on the question titles below to learn more.
Q: What is a spinal cord stimulator?
A: A spinal cord stimulator (SCS) is an implanted device composed of thin electrical wires. It is used to deliver low levels of electrical energy to the spinal nerves and spinal cord. SCS therapy was approved by the US Food and Drug Administration (FDA) in 1984, for those who have had countless, unsuccessful back surgeries and suffer from chronic pain in the arms, legs and back. Essentially, a spinal cord stimulator creates a low level of electricity to intercept the nerve conductors that are responsible for sending pain signals to the brain.
Q: How do I know if SCS therapy is right for me?
A: A screening test will help you and your doctor determine if SCS will provide the type of pain relief you have not been able to receive through less aggressive therapies, surgery and various medications. Your doctor will also take into consideration your full medical history, as well as the specific location and severity of your pain.
Q: How long will the screening take and will it hurt?
A: The screening test period or trial can take anywhere from 3 to 10 days and the procedure takes approximately 30 to 90 minutes. Local anesthesia will be administered when the leads are placed. The amount given will depend upon your pain tolerance. This part of the procedure can be occasionally uncomfortable and once the anesthesia wears off, you may experience some slight discomfort at the incision site. However, during the screening test period, the majority of patients are pain-free.
Q: Do I need to stop taking my pain medication before the trial?
A: As a rule of thumb, you should never stop taking your prescribed pain medication without the advice of your physician. However, your doctor may request that you stop taking oral medication 1 to 2 weeks before the test, or may simply reduce your dose. Pain medication may be given during the trial, if deemed necessary.
Q: What does it feel like?
A: While this differs from person to person, most patients report a warm, mild and consistent tingling sensation in the specific areas that they had previously experienced pain.
Q: How is the trial actually performed?
A: While this is an outpatient treatment, your oxygen and blood pressure will be monitored. You will be hooked up to an EKG in a sterile room. You will be given an external device that controls the electrodes attached to the leads placed behind and just outside the spinal cord in the epidural space.
There are four to eight evenly distributed electrodes that are programmed to create the appropriate amount of electricity. The electrodes will be placed under an x-ray while you lay flat on your stomach. Your skin and deeper tissues will be numb due to the local anesthesia.
The electrodes are injected through an introductory needle that passes into the epidural area. Adjustments are made until the stimulation from the electrodes successfully dulls the pain. Once you and your doctor are satisfied with the results, the needle is removed and the temporary wire is attached to the skin with a small stitch and bandage.
Q: Where exactly are the electrodes inserted?
A: The electrode placement depends on the specific area of your pain. Electrodes will be placed in the middle of the lower back if you experience pain in your lower back and legs. If you experience pain in your arms, the electrodes will be placed in the middle of your upper back.
Q: Where do the generators get placed?
A: The generator will be placed above the buttocks or on the side of the lower abdomen if you experience pain in your lower back and legs. If the pain is in your arms, the generator will be placed on the side of your chest.
Q: What should I expect after the procedure?
A: You should definitely arrange for transportation home and stay off of your feet for at least a few days after. It would be a good idea to refrain from excessive lifting, bending or twisting.
Q: How will I know if the trial is successful?
A: You should be able to answer this question yourself. If there is any doubt concerning the relief of pain, then your doctor will not consider fitting you with a permanent spinal cord stimulator. Generally, your doctor will be looking for either a significant and sustained reduction in chronic pain, an improved ability to function and participate in daily activities and a decrease in the need for oral pain medication.
Q: Is there a high success rate and is the procedure safe?
A: It is reported that patients who responded well to the trial will have a 50 to 70% decrease in their level of pain. This procedure is generally considered safe but as with any surgical procedure there will always be risks or side effects.
Q: What are the benefits?
A: Other than the obvious benefits of pain relief, a spinal cord stimulator can easily be removed if necessary. The device is not noticeable. It does not make any noise nor does it normally show through your clothes. After you’ve obtained a doctor’s approval and successfully completed the trial, insurance carriers will oftentimes pay for spinal cord stimulators and Medicare will pay 80% of the cost. For those of you in constant pain and have had no success with other treatments, it would be a good idea to get screened to see if a spinal cord stimulator is right for you.
To learn more about spinal cord stimulator trials or to schedule an appointment for treatment,contact us. We offer treatment in each of our Ocean County offices: Barnegat, Jackson, and Point Pleasant.