Spinal Cord Stimulation: Is it Right for You?
How does spinal stimulation work?
A small wire (called a lead) connected to a power source is surgically implanted under the skin. Low-level electrical signals are then transmitted through the lead to the spinal cord or to specific nerves to block pain signals from reaching the brain. Using a magnetic remote control, you can turn the current on and off, or adjust the intensity. The sensations derived from the stimulator are different for everyone; however, most patients describe it as a pleasant tingling feeling.
There are two kinds of systems available in spinal cord stimulation. The more commonly used system is a fully implanted unit that utilizes a pulse generator and a non-rechargeable battery that must be replaced over time. The second system relies on radio frequency and includes a transmitter and an antenna, which are carried outside the body (much like a pager or cell phone) and a receiver, which is implanted inside the body. Your physician will help you determine which system is better for you based on your condition, your lifestyle, and how much electrical energy is required to provide you with adequate pain relief.
Who is a good candidate for spinal stimulation?
This therapy is not for everyone. Generally, spinal cord stimulation may be considered when:
a) Conservative treatments have not been successful.
b) Surgery is not likely to help.
c) The patient has no untreated drug addictions.
d) The patient has had a psychological evaluation.
e) The patient does not have a pacemaker or other contraindications.
f) The patient has had a successful trial period with the spinal cord stimulator.
First step: The trial period
Before a spinal cord stimulation system is permanently implanted, most physicians recommend a trial period. During this time, a temporary stimulator is surgically implanted to allow you to try the therapy for a while (a minimum of 24 hours, but can be up to several weeks). This trial period is important to determine if the therapy provides satisfactory pain relief and is a good way to find out if you are comfortable with the sensations of spinal stimulation. If the system works for you, a permanent stimulation system can be implanted.
Next step: Implantation
Using a local anesthetic to numb the area, the surgeon will insert the wire lead through a needle or through a small incision. Once the lead has been implanted, the stimulation system will be activated and you will help the surgeon determine how well the system works on your pain.
The lead is connected to a receiver, which is implanted under the skin usually in the buttocks or abdominal area. However, other areas of the body can be used if these are not comfortable for you. Depending on your body shape and size, the receiver should not be easily visible through the skin.
You can expect some pain and swelling at the incision site and in the area where the receiver is implanted. This is normal and should only last a few days. Your doctor may prescribe a pain relief medication to help during this time.
Immediately following implantation, you should avoid lifting, bending, stretching, and twisting. However, light exercise, such as walking, is encouraged to build strength and help relieve pain.