Spinal Cord Stimulation Explained: Who Qualifies and What to Expect

Chronic pain affects millions of Americans each year, impacting daily life, mobility, and overall well-being. For those who have exhausted conservative treatment options like medication, physical therapy, or injections, Spinal Cord Stimulation (SCS) can offer renewed hope. But what exactly is spinal cord stimulation? Who qualifies for this advanced therapy, and what should patients expect before, during, and after the procedure?

In this comprehensive blog post, we’ll break down the science behind SCS, outline eligibility criteria, and explain the treatment process—helping you or a loved one make an informed decision about pain relief options.

What is Spinal Cord Stimulation?

Spinal cord stimulation is a minimally invasive pain management therapy that uses electrical impulses to disrupt pain signals traveling from the body to the brain. A small device, similar to a pacemaker, is implanted near the spine and connected to electrodes placed in the epidural space. The device sends mild electrical pulses that modify pain signals before they reach the brain, often replacing pain with a tingling sensation known as paresthesia.

The goal of spinal cord stimulation is not to eliminate the source of pain, but to alter the perception of pain, reducing discomfort and improving quality of life.

Conditions Treated with Spinal Cord Stimulation

SCS is primarily used for patients with chronic, intractable pain—pain that hasn’t responded well to traditional treatments. Common conditions treated with spinal cord stimulation include:

• Failed Back Surgery Syndrome (FBSS)

• Complex Regional Pain Syndrome (CRPS)

• Chronic lower back and leg pain

• Peripheral neuropathy

• Post-laminectomy syndrome

• Arachnoiditis

• Pain after multiple spine surgeries

• Diabetic neuropathy (in some cases)

The therapy is especially effective for nerve-related pain rather than muscular or joint pain.

Who Qualifies for Spinal Cord Stimulation?

Not everyone with chronic pain is a candidate for spinal cord stimulation. Ideal candidates typically meet the following criteria:

1. Chronic Pain Lasting Over 6 Months

Patients must have experienced persistent, severe pain for at least six months.

2. Failed Conservative Treatments

Candidates have usually undergone physical therapy, medication management, injections, and possibly even surgery—without satisfactory pain relief.

3. No Correctable Cause for Pain

If the underlying source of pain can be corrected through surgery or another medical treatment, SCS may not be the best first-line option.

4. Psychological Readiness

Patients must undergo a psychological evaluation to rule out conditions like severe depression or untreated anxiety, which can impact the success of the treatment.

5. Responsive to a Trial Period

A temporary trial of spinal cord stimulation (more below) must show at least 50% pain relief for permanent implantation to proceed.

The Spinal Cord Stimulator Trial

One of the most beneficial aspects of SCS is the trial period, allowing patients to “test drive” the therapy before committing to permanent implantation.

Here’s how the trial works:

• Under local anesthesia and sedation, a physician inserts temporary leads (thin wires) into the epidural space of the spine.

• The leads are connected to an external generator worn on the belt or over the shoulder.

• Patients go home for about 5 to 7 days and use the stimulator while performing regular activities.

• During the trial, patients track their pain relief and quality of life.

If the trial leads to significant reduction in pain (typically 50% or more) and increased activity levels, the next step is permanent implantation.

Permanent Spinal Cord Stimulator Implantation

If the trial is successful, patients may proceed with permanent implantation, which involves two main components:

1. Implanting the Electrodes
   Using a small incision, the surgeon places the leads in the epidural space—typically guided by fluoroscopy (live X-ray).

2. Inserting the Pulse Generator
   The generator is implanted under the skin, usually in the buttock or abdomen. It’s connected to the leads via extension wires.

The entire procedure is typically done on an outpatient basis, meaning patients can go home the same day.

Recovery and Aftercare

1. Recovery Time

Most patients experience mild soreness and fatigue for several days after the procedure. Light activity is encouraged, but strenuous movement and bending should be avoided for a few weeks.

2. Adjustments and Programming

One of the benefits of modern SCS systems is the ability to customize stimulation patterns. Pain specialists will work with patients post-surgery to fine-tune settings using an external remote.

3. Long-Term Care

Spinal cord stimulators typically last 5 to 10 years, depending on the device and usage. Rechargeable models are now common and can be maintained with at-home charging equipment.

Benefits of Spinal Cord Stimulation

Patients who undergo successful spinal cord stimulation often report:

• Significant pain relief (over 50% in many cases)

• Reduction in pain medication use, including opioids

• Improved mobility and function

• Better sleep and overall mood

• Greater participation in daily life

SCS is also reversible—if it’s not effective or causes issues, the system can be turned off or removed altogether.

Risks and Considerations

Like any medical procedure, spinal cord stimulation comes with risks. While complications are rare, they may include:

• Infection at the implant site

• Bleeding or nerve damage

• Device malfunction or migration of leads

• Spinal fluid leak

• Unwanted changes in stimulation

Thorough pre-procedural evaluation and follow-up care help minimize these risks.

Is Spinal Cord Stimulation Right for You?

If you’ve been living with chronic neuropathic pain and conservative treatments have failed, spinal cord stimulation could be a life-changing option. The therapy offers a reversible, drug-free, and often highly effective solution—especially for patients facing complex spine conditions.

The best way to find out if you’re a candidate is to consult a pain management specialist or interventional spine physician who offers SCS therapy. They can assess your medical history, guide you through the trial, and help determine whether spinal cord stimulation fits your treatment goals.

Conclusion

Spinal cord stimulation is no longer a “last resort” option—it’s a proven, evidence-based solution for certain types of chronic pain, especially those with a neuropathic component. Through a careful evaluation and a trial period, patients can explore whether this innovative therapy can help them reclaim their quality of life.

If you’re struggling with long-term pain and feel like you’ve run out of options, spinal cord stimulation may offer the relief you’ve been searching for.