When to Consider a Spinal Cord Stimulator for Your Chronic Back Pain

Coping with chronic back pain can completely rearrange your life and its priorities. You can be caught between the needs and burdens of pain management. Medication-based therapies work best over the short term, and you face drug resistance and addiction when trying to manage long-lasting pain, particularly when other, conservative treatments produce limited results. 

Dr. Jonathan D. Carlson specializes in pain management at his practice, Hawai’i Pain and Spine. For patients with chronic back pain, Dr. Carlson frequently recommends spinal cord stimulation, a drug-free way to change the way your body interprets the nerve signals creating chronic pain. 

The reasons behind pain

Nerves known as nociceptors typically detect tissue damage in your body and fire off messages to your brain. Your brain interprets this information as the pain you feel. When you experience chronic back pain, however, the nociceptors may be reporting on tissue damage that’s already healed. The nerves themselves become the source of the pain.

Spinal cord stimulators (SCS) use electrical neuromodulation to alter the pain signals between the nerves near the origin of your pain and your brain. This changes how your brain interprets the information sent through the nociceptors.

How SCS works

Spinal cord stimulators use precisely placed electrodes near the specific nerves that create pain signals. Powered by a battery similar to that in a pacemaker, the SCS generates low level electrical signals. This changes the nature of the signals produced by nociceptors, as well as the conversion of the signal into pain. Many patients experience a reduction or elimination of the pain sensations in their back. 

SCS systems come in different forms, though they all have a battery-powered pulse generator,  electrodes, and remote control. You have control over the level of electrical output and therefore, some control over the amount of relief that they deliver.

An SCS system won’t heal the cause of your pain, if one still exists. Instead of the chronic pain you’ve been living with, you may experience a fluttering sensation, tingling, or no sensation at all.

Candidates for SCS

If you’re in good health with no conditions that interfere with the SCS system or its implantation, you are likely a good candidate. Typically, there’s a trial period to determine if a spinal cord stimulator will work for you. A temporary device is placed with the guidance of a special type of X-ray, known as fluoroscopy, at the site of the nerves suspected of originating the pain signals. 

During the trial phase, only the electrodes are implanted. The rest of the device is worn externally. If your pain decreases by at least 50%, your trial period is usually considered a success.

Permanent implantation

Upon successful completion of your trial, a permanent SCS system is chosen and its implantation is scheduled. An outpatient procedure, implantation typically takes less than two hours under local anesthetic.

The procedure requires a small incision along the spine and replaces trial electrodes with their permanent versions. The generator is typically placed underneath your skin above your buttocks through another small incision. 

For the first few days, tenderness around the incisions is normal and you should try to avoid movements that can pull on your incisions, like stretching or twisting. Full healing can take up to two weeks. 

To learn more about SCS and the potential benefits it may offer you, contact Hawai’i Pain and Spine in Kailua. Call the office directly to schedule your consultation with Dr. Carlson. You may be able to reduce or eliminate the pain management drugs you’re currently taking. Book your appointment now. 



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