Treating Pain with Spinal Cord Stimulators: What You Need to Know

Explore how spinal cord stimulators offer relief for chronic pain, the procedure, benefits, risks, and who may benefit from this therapy.

By Medha deb

Created on Oct 3, 2025

Explore how spinal cord stimulators offer relief for chronic pain, the procedure, benefits, risks, and who may benefit from this therapy.

Treating Pain with Spinal Cord Stimulators

Chronic pain affects millions of people worldwide, often disrupting daily activities and quality of life. Traditional pain treatments such as medications, physical therapy, and surgery do not always provide sufficient relief. For individuals suffering from long-lasting, difficult-to-treat pain, spinal cord stimulators (SCS) represent an innovative and evolving option. This guide explains what spinal cord stimulators are, how they work, the implantation process, risks and benefits, and answers common questions for those considering this advanced therapy.

What Is a Spinal Cord Stimulator?

A spinal cord stimulator is a medical device implanted in the body to manage chronic pain, especially neuropathic pain that does not respond to other treatments. The device delivers mild electrical impulses to specific nerves in the spinal cord, interfering with or masking pain signals before they reach the brain. This technique, called neuromodulation, can significantly reduce pain sensations and improve quality of life for selected patients.

How It Works

The SCS system consists of thin wires (electrodes) placed in the epidural space near the spinal cord and a small battery-powered pulse generator (like a pacemaker) implanted under the skin, usually in the lower back or abdomen.
The generator sends controlled electrical pulses through the electrodes to the spinal cord.
The electrical stimulation interrupts pain signals traveling from the affected area to the brain, often replacing the pain with a mild tingling sensation known as paresthesia.
Modern devices may produce low- or high-frequency stimulation. Some advanced models create a pulseless stimulation that does not cause tingling at all.

Who Can Benefit from Spinal Cord Stimulation?

Spinal cord stimulators are not suitable for everyone with chronic pain. Typically, they are reserved for people who have not found relief with noninvasive therapies or are not candidates for further surgery. Common candidates include those with:

Failed back surgery syndrome (FBSS): Persistent pain after one or more back surgeries.
Complex regional pain syndrome (CRPS): A chronic pain condition affecting a limb, often after injury.
Peripheral neuropathy: Nerve pain commonly seen in diabetes.
Chronic pain following spinal cord injury or certain types of nerve injuries.
Post-amputation pain (phantom limb syndrome).
Angina or peripheral vascular disease (in select cases, under close specialist care).

Before proceeding, most patients undergo a thorough evaluation by a pain management specialist, neurologist, or neurosurgeon to determine suitability. A psychological assessment may also help identify issues that could affect outcomes.

How Is a Spinal Cord Stimulator Implanted?

Implanting a spinal cord stimulator involves several steps, typically completed in two stages: a trial period and the permanent implantation procedure.

Stage 1: The Trial Period

Purpose: To determine if the device provides adequate pain relief before making a permanent commitment.
Procedure: A temporary electrode is placed through a small needle in the back (similar to an epidural), guided by X-ray.
The electrodes are connected to an external pulse generator worn on a belt or carried in a pouch.
Duration: The trial usually lasts 5 to 7 days.
The patient continues daily activities while tracking changes in pain levels.

If the trial leads to a significant reduction in pain (generally at least 50%), many patients proceed to stage two: permanent implantation.

Stage 2: Permanent Implantation

Surgical Implantation: The permanent electrodes are placed in the epidural space using a minimally invasive technique. The pulse generator is implanted under the skin, often in the buttock or abdomen, and connected to the leads.
Programming: After healing, the system is programmed by the physician to deliver the optimal stimulation pattern and intensity, which can often be adjusted wirelessly.
Recovery: In most cases, patients return home the same day or after an overnight stay. Full recovery may take several weeks.

Types of Spinal Cord Stimulators

Not all spinal cord stimulators are the same. Advances in technology have produced a variety of devices and stimulation patterns:

Conventional SCS: Delivers continuous electrical pulses, typically causing paresthesia.
High-frequency SCS: Uses higher pulse rates and may not produce any tingling sensation, potentially offering pain relief without paresthesia.
Burst stimulation: Delivers electrodes in closely spaced groups (bursts), potentially mimicking natural nerve firing patterns and reducing awareness of stimulation.
Rechargeable and Wireless Options: Some systems use rechargeable batteries, while others may offer wireless programming and control features.

Benefits of Spinal Cord Stimulators

Reduction in Pain: Many people report significant and lasting improvement in pain levels (commonly 50% or more).
Decreased Reliance on Medications: SCS may help patients reduce the use of opioids and other pain medications, lowering the risk of side effects and addiction.
Improved Quality of Life: With better pain control, patients often experience increased mobility, sleep, and ability to participate in daily and social activities.
Reversible and Adjustable: The system can be turned off, adjusted, or even removed if not effective or needed.
Minimally Invasive Procedure: Implantation typically involves less risk and recovery time compared to major surgeries.

Risks and Limitations of Spinal Cord Stimulation

As with any medical device or procedure, spinal cord stimulation has risks and may not be suitable for every patient.

Infection: As with any surgical procedure, there is a risk of infection at the implant site.
Device Complications: Lead migration (movement of the electrodes), hardware malfunction, or battery failure can occur, potentially requiring reprogramming or revision surgery.
Pain at Implant Site: Some patients experience discomfort or pain at the location of the generator or electrodes.
Results Vary: Not all patients achieve satisfactory pain relief. Some may see no improvement.
Limitations During Imaging: Most older devices are not MRI-compatible, although newer systems may allow for certain types of MRI scanning with precautions.
Cost and Insurance: SCS implantation is expensive and may not be covered by all insurance plans for every condition.

Who Is Not a Candidate?

Active Infection: Patients with active local or systemic infections should not be considered for SCS until infections are cleared.
Blood Clotting Disorders: Those with bleeding tendencies may not be suitable due to increased risk of bleeding during implantation.
Psychological Contraindications: Severe untreated psychiatric conditions may negatively affect outcomes.

What To Expect After Getting a Spinal Cord Stimulator

Most individuals with a spinal cord stimulator:

Return home the same day or the day after the procedure.
May have restrictions on lifting, bending, or twisting for several weeks to prevent lead movement while healing.
Receive instructions on caring for incision sites to reduce infection risk.
Attend follow-up visits for device programming and monitoring effectiveness.
Work with medical providers to adjust the stimulation settings for sustained pain relief and minimal side effects.

Most devices are designed for patients to control the stimulator with an external remote, adjusting settings depending on activity, position, or pain levels.

Living with a Spinal Cord Stimulator

Patients with spinal cord stimulators can usually continue most normal activities. Some considerations include:

Devices may trigger security sensors in airports or some buildings—patients should carry an identification card describing the implant.
High-contact sports or heavy labor may risk wire breakage or movement; discuss limitations with your healthcare provider.
Emergencies: Let medical personnel know about the device before imaging (especially MRI) or surgery.
Battery life for nonrechargeable units is several years; rechargeable models last longer but need regular charging.

Frequently Asked Questions (FAQs)

How does a spinal cord stimulator help control pain?

An SCS delivers electrical impulses to the spinal cord, interfering with and masking pain signals before they reach the brain. This often transforms pain into a tingling or, in some cases, eliminates sensation of pain completely depending on the device and stimulation mode.

Is the spinal cord stimulator procedure reversible?

Yes. The device can be turned off, removed, or reprogrammed if it does not provide desired relief or causes side effects.

What are the risks of having a spinal cord stimulator?

Risks include infection, bleeding, device malfunction, lead movement, pain at the implant site, and, in rare cases, spinal cord injury. Discuss the risks and benefits with your medical provider thoroughly.

Will I feel the stimulator working?

Many patients feel a mild tingling (paresthesia) when the device is active, but newer models can deliver stimulation that you do not feel at all.

Can I still have an MRI after getting a spinal cord stimulator?

Older devices may not be MRI-compatible. Newer models often allow for limited MRI scans with special precautions—ask your care team about the specifics of your implanted system.

Will insurance cover the cost?

Insurance coverage varies. Many policies cover the device for approved chronic pain conditions, particularly failed back surgery syndrome or CRPS, but coverage may differ for other uses.

What happens if the spinal cord stimulator stops working?

The device can be checked and reprogrammed by your provider. Hardware failures or battery exhaustion typically require simple surgery to repair or replace the parts.

Summary Table: Pros and Cons of Spinal Cord Stimulation

Pros	Cons
Significant pain reduction for many patients	Not everyone responds (pain relief varies)
Decreased reliance on pain medications	Implantation involves surgery and its risks
Reversible/interruption does not preclude other options	Possibility of infection, device failure, or lead migration
Improved daily function and quality of life	Some device limitations (MRI compatibility, battery life)

Key Takeaways

Spinal cord stimulation is a promising therapy for chronic pain, especially for those who have not found relief with other treatments.
The trial period allows most people to test the effectiveness before committing to permanent implantation.
Not all patients respond to SCS; careful evaluation by specialists helps determine candidacy.
The procedure is generally safe, minimally invasive, and reversible, but carries risks like any implantable device.
Technology is advancing, providing options tailored to diverse patient needs and pain patterns.

For those living with persistent, debilitating pain, spinal cord stimulation offers hope and the prospect of regaining quality of life. If you or someone you know is struggling with chronic pain, consult a pain management specialist to see if a spinal cord stimulator is an appropriate option.

References

Author

medha deb

Medha Deb is an editor with a master's degree in Applied Linguistics from the University of Hyderabad. She believes that her qualification has helped her develop a deep understanding of language and its application in various contexts.

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