Spinal Cord Stimulator (SCS) Therapy: A Modern Approach to Chronic Pain Management

Chronic pain can significantly affect daily activities, sleep, mobility, and emotional well-being. For individuals whose pain has not improved with conservative treatments, Spinal Cord Stimulator (SCS) therapy may offer an option for relief and improved quality of life.

What Is a Spinal Cord Stimulator?

A Spinal Cord Stimulator (SCS) is an implantable medical device that helps manage chronic pain. It works by delivering mild electrical pulses to specific areas of the spinal cord. These pulses interfere with or change the way pain signals travel to the brain, which may reduce the sensation of pain.
SCS therapy is commonly used when other treatments—such as medications, physical therapy, or surgery—have not provided adequate relief.

Conditions that may benefit from SCS include:

• Chronic back and leg pain
• Neuropathic (nerve-related) pain
• Failed Back Surgery Syndrome (FBSS)
• Complex Regional Pain Syndrome (CRPS)
• Peripheral neuropathy in select cases (depending on evaluation)

How the SCS System Works

An SCS system typically consists of three parts:
1.Implantable Pulse Generator (IPG):
A small battery-powered device, similar in size to a cardiac pacemaker, implanted beneath the skin (usually in the buttock or abdomen). It generates electrical impulses.

2.Leads (electrodes):
Thin, flexible wires are positioned in the epidural space along the spinal cord. They transmit electrical impulses from the IPG to targeted nerve pathways.

3.External Controller:
The external controller is a handheld remote that allows the patient to adjust settings, such as stimulation intensity, and turn the device on or off. Clinicians can also program more advanced settings through a separate programmer.

Benefits of SCS Therapy

While results vary among patients, potential benefits include:
1.Individualized Pain Relief
The device can be programmed and adjusted to meet each patient’s specific pain patterns.

2.Minimally Invasive Surgical Procedure
Although implantation requires surgery, it is typically performed using small incisions in an outpatient setting.

3.Improved functionality and Quality of Life
Many patients experience reduced pain levels, better mobility, and improved ability to perform daily activities.

4.Potential Reduction in Pain Medication Use
SCS may decrease reliance on long-term pain medications, including opioids, when appropriate.

Important: SCS is not a cure for pain but a tool used to help manage and reduce pain.

Steps in the SCS Treatment Process

1.Comprehensive Evaluation
A pain management specialist evaluates the patient’s medical history, imaging studies, and prior treatments to determine if SCS is appropriate.

2.Trial Stimulation
Temporary leads are placed on the spinal cord without implanting the battery. The trial usually lasts 3–7 days to evaluate how much pain reduction the patient experiences.

3.Permanent Implantation
If the trial provides meaningful pain relief (commonly defined as ≥ 50% reduction in pain or improved function), a permanent stimulator is implanted under local or general anesthesia.

4.Programming and Follow-Up
After healing, the device is programmed to optimize pain control. Follow-up visits help fine-tune settings and address any issues.

Living With an SCS Implant

Most patients can return to their daily activities gradually after healing. The stimulator can be adjusted throughout the day to match changing pain levels or activities, giving patients more control over their pain management.

Is SCS Right for You?
SCS may be considered for individuals who:

• Have chronic pain that has lasted longer than 6 months
• Have not achieved relief from other therapies
• Are willing to undergo a trial to evaluate effectiveness

A consultation with a pain management specialist is essential to determine candidacy.

Take the Next Step
Chronic pain does not have to dictate your future. If you or a loved one is struggling with persistent pain that has not responded to traditional treatments, talk to your healthcare provider or pain management specialist about whether Spinal Cord Stimulator therapy may be an option.