Spinal Cord Stimulation

What is spinal cord stimulation?

Spinal cord stimulation is a treatment modality that uses low-level electrical impulses to block pain signals from being sent up the spinal cord to the brain, where they are registered as pain or discomfort. They are sometimes referred to in jest as the “pacemakers for pain,” as the electrical principles they rely on are similar to those us by the implant that keeps faulty hearts pumping. The overall goal of a spinal cord stimulator is to use these short burst of low-voltage electricity to essentially override the pain signals being sent through the spinal cord; by doing so, they can help prevent the brain from processing pain signals from the nervous system.

How is spinal cord stimulation performed?

A spinal cord stimulator is a medical device or implant that is placed near the spinal cord to counteract pain signals. It has small wires or leads that carry the electrical impulses from the generator, which is typically placed near the hip, into the epidural space, where they interact with the spinal cord and scramble pain signals being sent to the brain. Stimulators are generally implanted surgically, with the leads being placed near the spinal cord in the epidural space and the generator being placed near the top of the buttocks or hip. Once the device has been implanted, patients generally have an external remote or controller that allows them to modulate the intensity and frequency of the electrical signals.

If your physician believes you are a candidate for a spinal cord stimulator, they will generally start by conducting a trial period with a temporary spinal cord stimulator. If this trial proves successful, your physician will move on to implanting a permanent stimulator to give you lasting relief. It’s important to remember that a psychological evaluation must be completed before the implantation of any medical device. 

Type of stimulators

There are a wide variety of spinal cord stimulators available to patients and physicians, but they generally fall into one of three categories: conventional implantable pulse generators, rechargeable implantable pulse generators, and radiofrequency stimulators.

Conventional implantable pulse generator (IPG)

IPGs consist of a generator, generally placed near the hip or buttocks, and small wire leads which run into the epidural space and carry the electrical impulses to the spinal cord. When the battery that powers the generator runs out, the patient must undergo another surgery to replace. IPGs are typically a good choice for people with pain in just one part of the body because their injury requires less “power” to manage.

Rechargeable implantable pulse generator

Similar to the conventional implantable pulse generator, a rechargeable implantable pulse generator consists of a generator, generally placed near the hip or buttocks, and small wire leads which run into the epidural space and carry the electrical impulses to the spinal cord. However, unlike an IPG, these devices can be recharged without another surgery. Because the power source for these generators is rechargeable, these generators generally are capable of putting out more electricity, so they are a better choice for people with pain in the lower back or in one or both legs, as these require more “power” to manage.

Radiofrequency stimulator

Radiofrequency stimulators are an older design and rely on a battery that’s located outside the body. This stimulator is rarely used today because of newer designs and better technology, like rechargeable batteries. Similar to rechargeable IPGs, however, radiofrequency stimulators may be better for people with pain in the lower back and legs because of the increased power these devices are capable of generating.

Types of Conditions Treated

Chronic conditions like spinal stenosis, failed back surgery, neuropathic pain, and degenerative disc syndrome generally respond well to the use of spinal cord stimulators. It is thought that these conditions respond favorably to spinal cord stimulation because the pain being treated is caused by nerve-related conditions. By blocking the pain signals emanating from these nerve-based conditions, spinal cord stimulation can help control and manage these conditions and improve overall quality of life. Furthermore, spinal cord stimulation can reduce the need for pain medicines.

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