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When everything else fails to relieve back pain including surgery, spinal cord stimulation may be an additional option. It’s the most common neuromodulation technique used today. Unlike most surgical treatments, you can try spinal cord stimulation temporarily to see if it works for you.
Spinal cord stimulation (SCS) uses an implant to deliver mild electrical signals that disrupt the pain sensations transmitted by nerves. First used in 1967, and approved by the Food and Drug Administration for pain relief in 1989, about 14,000 implants are done worldwide every year. Working much like a heart pacemaker, SCS implants are getting smaller. Since these are a way to reduce long-term opioid use for chronic pain management, interest in the devices continues to grow.
A similar technology, called peripheral nerve field stimulation, works in much the same way, but these devices aren’t planted as deeply into the body. It’s possible to use both peripheral nerve field stimulators and SCS devices together.
SCS doesn’t truly stop the pain, since the condition that causes pain remains. The signals from the device mask pain signals before they make it to the brain, so the change is one of perception, not a cure or healing method. Pain sensations are either not felt at all or replaced by a tingling sensation.
Some pain may remain. It’s typical for an SCS device to reduce pain, which in turn can lessen your dependency on opioid pain medications. Because the SCS device only masks pain, individual results vary significantly. The goal for most implant treatments is a reduction of pain of about 50%-70%, enough to remove chronic pain as a factor that interferes with daily life.
Because of the nature of the technology and the variability of results, trial stimulation is typically done before a permanent implant, so you can see if it will work with your pain as well as experiencing the sensations that SCS devices create.
As with any surgery, there are risks of surrounding tissue damage, infection, blood clots, and reactions to anesthetics. In the case of SCS implants, risks include: