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How we replace chronic pain with a pleasant tingling sensation

June 15, 2016 | Ariana Nelson, MD
Hand on back for pain

Sometimes nerves malfunction.

If you have nerve-related chronic pain, your nerves may be sending pain signals to your brain even after an injury has healed.

What if there was a way to replace that pain with a mild pleasant tingling sensation instead?

There may be. It’s called spinal cord stimulation.

While this particular pain management technique will not fix the anatomical problem or eliminate the pain entirely, it may allow you to be more active with less pain.

How a spinal cord stimulator works

A spinal cord stimulator consists of a thin catheter that we place in the space just outside the spinal cord (known as the epidural space). The catheter, which is attached to a small generator to power the device, has tiny electrodes on the end of it that stimulate the nerve fibers.

The generator sends a mild electric current through the catheter to the nerve fibers of the spinal cord, creating a mild tingling sensation and blocking the pain signal from reaching the brain.

Determining effectiveness

To determine whether this treatment would be effective in relieving your pain, we start you off with a temporary device. We insert a catheter attached to a small generator that you can carry or wear on a belt. This process is no more involved than most pain injections. The generator is programmed to automatically send the stimulation to your nerves. Then we’ll send you home to go about your daily business for a few days so you can experience it in your natural environment.

If the spinal cord stimulation reduces your pain, we’ll place a more permanent device.

While we will insert the same kind of catheter as in the trial, we’ll surgically place the generator under the skin, rather than having you carry it. This way, nothing is visible from the outside. You could even wear a swimsuit — no one will notice the generator. This procedure involves a tiny incision and normally does not require an overnight hospital stay.

Before you leave the hospital, you will receive a remote control that allows you to turn the device on and off and adjust the stimulation based on the severity of the pain.

Is spinal cord stimulation right for you?

Spinal cord stimulation works best for patients with nerve-related chronic pain in any part of the body below the neck — such as the legs, arms or back.

Spinal cord stimulation may not always prove to be a treatment option for chronic pain.

Most studies show up to 60 percent of patients find meaningful pain relief through spinal cord stimulation. However, the amount of pain relief varies by patient. We look for a 50 percent to 70 percent reduction in pain to consider spinal cord stimulation worth pursuing.

Also, a few patients find they do not like the tingling sensation that the stimulation produces.

Before we begin spinal cord stimulation, we take into account whether other pain management techniques have been tried. We also make sure:

  • The source of pain has been identified.
  • You have no medical conditions that would rule out implantation surgery.
  • You have had a successful trial with a temporary stimulator.

How long can spinal cord stimulators be used?

Spinal cord stimulators can be a long-term solution, but they are not permanent. If the device becomes less effective at managing your pain, we’ll remove it and try something else.

However, if spinal cord stimulation eases your pain effectively, it can stay implanted for decades. The generator’s battery is FDA-approved for 10 years, so you would need to have it replaced, but that is a very minor procedure. 

The spinal cord stimulator is similar to a pacemaker, so devices such as cellphones, microwaves and anti-theft sensors will not interfere with it. It can be detected at airport security gates, so make sure to carry your implanted device ID card with you.

Next steps in spinal cord stimulation research

This technology has been around since the 1950s, but it wasn’t until the early 2000s when it suddenly took off because of rechargeable batteries and better programming options that help interrupt the multiple pain signals being sent.

Pain signals are not the same all the time. You may experience more pain at certain times of the day or during certain activities. To cover all those facets of pain, we needed multiple ways to block the different signals.

Research has come a long way and we continue to push for better results by, for example, comparing high-frequency signaling to low-frequency signaling and the number of electrodes used. In doing so, we hope to decrease your pain even further so you can continue to live life to the fullest.

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