When it comes to lifelong or chronic pain, there are several treatment options a doctor would recommend, but our primary goal is typically management rather than finding its cure. One of the most common and effective management options that many patients with chronic pain opt for is spinal cord stimulation (SCS).
Advances in SCS technology allow patients with lifelong spine-related pain to eliminate or reduce their overreliance on painkillers and return to the comfortable and productive lives they enjoy. If you have chronic pain that does not disappear with pain medications, physical therapy, or other non-surgical treatment options, surgical placement of a spinal cord stimulator implant could help.
Los Angeles pain specialists at LAMIS institute can help you determine whether this surgical treatment option would be best for your unique bothersome condition. Keep reading this article for more information about this life-changing pain management technology.
Quick Facts About SCS Implant
SCS implant is a device that a neurosurgeon implants in your spine to deliver electrical impulses that help block or disrupt pain signals from reaching the brain whenever your body comes into contact with pain stimuli.
Instead of experiencing bothersome pain whenever your body comes into contact with pain stimuli, the stimulator's electrical impulses will mask the pain and replace it with a mild tingling sensation. Below are the components that make the SCS system effective as a pain management solution for people with chronic pain:
- Neurostimulator — This is a small-sized device (generator) that your neurosurgeon will surgically implant underneath your skin, typically near your abdomen or buttocks, to send electrical impulses in your spinal nerves through a wire (lead).
- Electrodes — These are thin lead wires which your neurosurgeon will place in between your vertebrae and spinal cord (epidural space) to help transmit electrical impulses generated by the neurostimulator.
- Charger — Most neurostimulators will have a rechargeable battery which will require you to charge it for approximately one hour after every two weeks.
- Remote control — A remote is also a critical component of the SCS system. The remote will allow you to turn the generator on and off or increase and decrease the stimulation level whenever your body comes into contact with pain stimuli.
Due to advancements in technology, there are a variety of SCS implants that you could choose to manage your annoying pain issue. Your neurosurgeon will help you choose the best and most cost-effective device for your unique condition.
Types of Chronic Pain That SCS System Can Help to Manage or Reduce
As long as your SCS trial was a success, there are no risks of complications during the surgery, and you are not pregnant, you could be an excellent candidate for this surgical pain management technique. Some of the most common chronic pain conditions that are manageable using the SCS system include:
- Post-surgical pain.
- Back pain.
- Heart pain (angina).
- Spinal cord injuries.
- Peripheral vascular disease.
- Perineal pain.
- Pain caused by amputation.
- Nerve-related pain, for example, diabetic neuropathy.
Generally speaking, having the SCS system implanted in your body can help improve your life's quality and lessen the overreliance on painkillers to manage your chronic pain. After surgical placement of the SCS system in your body, your neurosurgeon could also recommend other pain management remedies after a certain period to help keep the uncomfortable pain at bay.
Common pain management remedies your neurosurgeon could recommend after this treatment include the following:
- Stretching exercises like yoga.
- Physical therapy.
- Particular exercises.
- Pain medications.
Preparations Needed Before SCS System Placement Surgery
Before undergoing the SCS system placement surgery, adequate preparation is necessary to avoid any possible and unnecessary complications. First, your neurosurgeon will conduct imaging and diagnostics tests on you, including X-rays, to ensure you are healthy for this surgery.
These imaging and diagnostic tests are also crucial to rule out any other possible condition or circumstance that could indicate you are not an excellent candidate for the procedure. Since some psychological disorders like anxiety could affect the success of this treatment, your neurosurgeon could work with a psychologist to determine if you are mentally fit for the procedure.
Once your neurosurgeon clears you for surgery, he/she will give you guidance and information on preparing for the procedure. Typically, your neurosurgeon will require you to tell him/her if:
- You are currently on medication and the type of medications you are taking because some drugs could increase the risk of excessive bleeding and even slow the healing process after surgery.
- You smoke cigarettes or use any other tobacco product because it can slow the healing the process.
- You have blood clotting problems.
- You have high BP (blood pressure) or diabetes.
- You have allergies.
Since this procedure will require sedatives or general anesthesia to numb your skin, your neurosurgeon will also require you to fast for at least eight hours before your surgery time. Once your neurosurgeon finds that you are an excellent candidate for this procedure and are well-prepared, he/she will schedule you for a trial of the SCS therapy.
The purpose of the SCS therapy trial is to determine the effectiveness of the implant in managing your pain and test your tolerance to the SCS devices in your body.
What to Expect During and After the SCS Therapy Trial
A trial procedure is typically a "test drive" to determine if the permanent SCS devices will work in your favor to manage your unique chronic pain condition. Your healthcare provider or neurosurgeon will perform this procedure at the outpatient center. Before the procedure, the neurosurgeon will use sedatives or local anesthesia to number the incision site.
Then, he/she will use fluoroscopy to insert a thin hollow needle into your epidural space. Once the hollow needle is in place, he/she will thread and position the trial leads over specific targeted nerves, leaving parts of the temporary leads outside the skin.
After that, your neurosurgeon will connect the ends of the leads to an external electrical impulse generator, which you will likely wear on a belt. Once the SCS trial system is in place, the neurosurgeon will give you instructions to help you operate it while at home whenever you experience a pain sensation.
Remember to take notes on how effectively this trial works to manage your uncomfortable pain. After about four to seven days, the neurosurgeon will expect you to return to his/her clinic to remove the trial SCS system from your body, and your notes will help determine if it was a success. Typically, the neurosurgeon will consider this trial success as long as it can relieve at least 50% of your pain.
Permanent SCS System Placement Surgery
If your trial procedure was a success, your neurosurgeon will remove the temporary electrodes during your second appointment and then insert permanent electrodes using the same incision. However, you will be under sedation or anesthesia during the placement of the permanent SCS system, meaning you will not feel any pain or discomfort during the procedure.
Typically, the process of permanent SCS system placement is similar to the trial procedure. However, during permanent SCS system placement surgery, the electrodes and the electrical impulse generator will remain underneath your skin.
The specific part of your body where the neurosurgeon will place the electrical impulse generator will depend on several factors, for example, your sleeping position preference. In most cases, your neurosurgeon will place the generator on your buttocks or any preferred side of your belly.
Once your neurosurgeon completes the implantation of the permanent SCS system underneath your skin, he/she will use staples to close the incision site. Unlike the trial SCS placement surgery, the neurosurgeon could require you to remain in the hospital for one to two days after this second surgery.
Before you leave the neurosurgeon's clinic, he/she will program your impulse generator and hand you written instructions on how to operate it at home. After being discharged from the clinic, your neurosurgeon will also require you to return after about a week to monitor the healing process to ensure there are no chances of bacterial infection.
Remember to carry your remote with you during your follow-up appointment because your specialist could need to adjust the device's programming to achieve the desired results.
Possible Complications and Side Effects After SCS Implant Placement Surgery
While it is rare, some patients could experience the following complications and side effects after undergoing SCS implant placement surgery:
- Pain at the incision site.
- Nerve damage or partial paralysis.
- Bacterial infection.
- Generator failure or malfunction.
- Lead (electrodes) could break or shift out of position.
When a qualified and experienced neurosurgeon performs your SCS implant placement surgery, the above possible risks and side effects will be rare. In addition to being qualified and experienced, ensure the neurosurgeon or pain specialist you will decide to consult for your chronic pain treatment is:
- Certified and accredited.
- Credible and reputable.
- Accessible and available.
What to Avoid After SCS Implant Placement Underneath Your Skin
For healing of the incision site and to avoid any possible complications after this pain management surgery, your neurosurgeon or pain specialist will require you to avoid the following:
- Lifting anything that weighs more than five pounds.
- Driving before your follow-up appointment, especially if the implant is active.
- Performing any strenuous activity, including sex, housework, or yard work.
- Consuming alcohol because it makes your blood thin, increasing the risk of bleeding.
How to Care for the Incision Site After SCS Implant Placement Surgery
After SCS implant placement surgery, you should care for the incision site to avoid infection and accelerate the healing process. Here are helpful tips on how to care for the incision site after your surgery:
- Do not apply ointment or lotion on the incision site.
- Wash and sanitize your hands before and after washing the incision site.
- Do not soak your incision site in a pool or bath.
- Gently wash your incision site with the recommended soap and water daily.
- Watch out for any colored discharge from the incision site because it could be a sign of infection.
Applying ice wrapped on a soft cloth on the incision site can help reduce discomfort and swelling after your SCS implant placement surgery. However, if the pain persists or you detect any pinkish discharge from the incision site, you should schedule an emergency appointment with your neurosurgeon.
Potential Advantages of SCS Therapy
In addition to reducing your uncomfortable and bothersome chronic pain, other advantages of SCS therapy include the following:
- Improved sleep.
- Reduced narcotic use.
- Improved functioning.
- Increased mobility and activity.
It is worth noting that the effects of SCS therapy could vary from patient to patient and could help reduce bothersome chronic pain, but it will not eliminate it.
Life After SCS Therapy
Generally speaking, the pain relief you will experience after SCS therapy allows you to do more activities than you would before this surgery. However, you should be ready to adjust your lifestyle once you have your SCS implant. Below are restrictions or precautions to keep in mind after this therapy:
- Before undergoing any medical screening like computer tomography (CT) scan, magnetic resonance imaging (MRI), or X-ray, you should let your health provider know that you have the SCS implant in your body. Specifically, if your implant is not compatible with MRI, this scan could cause injury.
- When passing through airport security check-up, remember to switch off your device to avoid unnecessary interference with your travel plans or delays.
- When driving or operating any heavy equipment or machinery, it is also advisable to turn off your device because sudden changes in the device's stimulation level could cause unwanted disruption.
It could take a while to adapt to living your life with the SCS implant in your body, but it will undoubtedly improve your quality of life. Fortunately, if you are unhappy or unsatisfied with this device's effects on your chronic pain, you can have it removed safely for other alternative pain management remedies.
Find a Pain Specialist Near Me
Whether or not you should undergo SCS therapy to alleviate your bothersome chronic pain depends on your unique risks and needs. Your pain specialist or neurosurgeon can help you determine if this surgical pain management remedy will work for you. Experienced pain specialists at LAMIS Institute can provide the cost-effective SCS therapy you need for your unique pain condition.
We are committed to offering the best and most timely pain management services to all patients with life-long pain issues in Los Angeles. Call us at 310-734-6088 to schedule your first obligation-free consultation with our reputable pain specialists.