How Does a Spinal Cord Stimulator Trial Work?

Your struggle with chronic pain has been a long and frustrating one, and you have little to show for your efforts — namely, relief from your pain. 

Though conversations with friends and family might reveal how common chronic pain is in your world, we're going to put some broader numbers to the problem — more than one in five American adults (nearly 52 million people) reports chronic pain.

As specialists in neurosurgery and the behavior of pain, Dr. Ali H. Mesiwala and our team are well aware of the overall pain burden in our country, and we want to do our part to help. One treatment that’s gaining more traction is spinal cord stimulation (SCS), and we describe this innovative approach to pain management here, including the initial trial period.

How spinal cord stimulation works

Pain is a back-and-forth process that involves your peripheral and central nervous systems. Your central nervous system includes your brain and spinal cord, and your peripheral nervous system includes all your nerves outside these areas, which mostly branch out from 31 pairs of nerve roots that exit your spinal canal. 

When you experience pain, sensory nerves register harmful stimuli and send that message to your brain through your spinal cord. When the message reaches your brain, it interprets the signal and translates it into pain.

This can happen over the course of years due to compression of the nerves, resulting in nerve damage or nerve damage due to an injury. 

The concept behind spinal cord stimulation (SCS) is relatively simple — we disrupt the pain signaling between your central and peripheral nervous systems. Imagine, if you will a frequency that the pain signal is traveling at, and the stimulator transmits a signal that basically drowns out the pain signal. 

To do this, we place electrodes around your spinal cord that emit mild electrical pulses that disrupt the pain communications between your brain and your peripheral nerves. 

Types of pain that spinal cord stimulation can tackle

At our practice, we turn to SCS, which is a form of neuromodulation, for a wide range of chronic pain issues, such as:

• Low back pain
• Cancer pain
• Peripheral neuropathy pain
• Complex regional pain syndrome
• Cancer pain
• Post-surgical pain
• Phantom limb pain

This list is far from comprehensive, but it gives you a better idea of the breadth and scope of applications for SCS.

Undergoing a neuromodulation trial period

There are many benefits of this approach to pain management, and one that we find useful is that we can conduct a trial period to see if SCS works to relieve your pain.

During this trial period, we insert electrodes into the epidural space around your spinal cord during a minimally invasive, in-office procedure. These electrodes are powered by an external generator pack that you wear like a belt. You can control the generator, within pre-programmed ranges, to manage your pain when it strikes.

In most cases, this SCS trial period lasts for about a week, so we can get an idea of whether neuromodulation works to control your pain. If you experience at least a 50% reduction in your pain, then we deem your spinal cord stimulation trial a success, and we can make arrangements to implant a more permanent device.

When we say permanent, it means that we implant a small generator just below your skin, but rest assured, we can easily remove the generator and electrodes at any time.

This is a treatment option that has been available to patients for a long time, but in the last decade or so made significant improvements in how that therapy is delivered.

We are able to offer this to our patients a treatment modality for managing their chronic pain syndromes and decrease the need for the use of oral pain medication or a pain pump. 

Surgeons performing this procedure make the determination based on the medical history, physical exam, radiological findings, and a trial before undergoing a permanent implant. It is a comprehensive work up and should be discussed with your physicians in detail. 

The surgery it self can be performed in the outpatient setting, and patients typically go home the same day. Within 2 weeks patients are typically back to their normal level of activities. 

If you’d like to explore undergoing a trial for spinal cord stimulation, we invite you to contact one of our offices in Newport Beach, Marina del Rey, or Rancho Cucamonga, California, to schedule a consultation with Dr. Mesiwala.