What Is a Spinal Cord Stimulation Trial?

A trial spinal cord stimulator can help you and your doctor decide if this therapy is the right choice to reduce and manage your back/neck pain.

A spinal cord stimulation trial period is necessary if you are considering this treatment to reduce and manage your chronic pain. The level of pain relief and effect of spinal cord stimulation (SCS) varies from person to person, and makes it important to test how well your pain responds to neuromodulation (blocks nerve/pain signals) before the device is permanently implanted.

Setting Up the SCS Trial Device

The SCS trial device components (eg, lead, neurostimulator) are set up and attached to you during an outpatient procedure performed by a spine surgeon or pain management specialist. A local anesthetic is injected to manage pain. The procedure takes approximately 30 to 90 minutes.

During the procedure, a needle is inserted into the spine’s epidural space similar to the way a spinal steroid injection is performed or placement of an epidural catheter for child-birth. After the needle is in the proper position, temporary wires (called leads) are threaded through the needle into the epidural space (see the anatomical image below) and advanced up to the target level. The target level is typically several inches above the needle insertion site. Sometimes, one lead is inserted, other times several are used.

epidural space in the lumbar spineDuring the procedure, a needle is inserted into the spine’s epidural space similar to the way a spinal steroid injection is performed. Photo Source: 123RF.com.The lead (or leads) is connected to the stimulator and repositioned to make sure placement of the electrode (lead) covers the areas where you feel pain. Then, the electrode is secured to your skin with a suture and/or surgical dressing. The trial neurostimulator is about the size of a deck of cards. It is taped to the skin on your back. A handheld programming device controls the neurostimulator.

How Long Does the SCS Trial Last?

A spinal cord stimulator trial period is at least 5 to 7 days. This gives you time to test the device and evaluate its effectiveness managing your pain at rest and during activity. While SCS may not completely eliminate your pain, a 50% reduction in pain is considered a successful trial. A growing number of physicians now focus on improved quality of life, not only on the percentage of pain reduction.

Track Your Symptoms and Functioning

It is important to keep a record of your pain throughout the spinal cord stimulation trial period. Your doctor may provide a "pain log sheet" to help you track your pain levels and experiences using the SCS. Listed below are things to keep in mind when evaluating your pain levels:

  • Does SCS reduce your pain and how much?
  • Can you perform more of your daily activities?
  • Does SCS reduce your need for pain medication?
  • Has the quality of your sleep improved?
  • Your doctor may ask you to track additional measures.

If your pain is not reduced during the trial, it is important to tell your doctor. During the trial, the representative from the company that makes the stimulator will contact you, and may perform additional changes to the device to better cover and manage your pain.

Since the trial neurostimulator is placed outside of your body, the device cannot get wet. While you can take a sponge bath, do not take a full bath or shower during the trial. In addition, do not engage in any strenuous activities that could possibly pull the leads out of place. These restrictions do not apply to the permanently implanted system.

Ending the Trial

The electrodes are removed at the follow-up visit in your doctor’s office. It is typically no more painful than having an IV or catheter removed.

See our other articles about SCS:

Updated on: 08/07/19
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