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952-841-23455 Questions to Ask Your Spinal Cord Stimulator Doctor Before Treatment
When chronic pain affects your daily life, finding the right treatment becomes a priority. Spinal cord stimulation might be the solution you need. However, choosing the right doctor requires careful consideration and informed questions.
Spinal cord stimulators help many people find relief from chronic pain conditions. These devices send mild electrical pulses to your spinal cord to block pain signals. Before you move forward with this treatment, asking the right questions ensures you make the best decision for your health.
In this article, we will explore the top five questions you should ask your doctor before your treatment.
What conditions do you treat with a spinal cord stimulator?
Your doctor should clearly explain which conditions respond well to spinal cord stimulation. The most common include:
- Failed back surgery syndrome (persistent back pain after surgery)
- Chronic back pain that hasn’t responded to other treatments
- Complex regional pain syndrome (CRPS)
- Diabetic neuropathy
- Peripheral neuropathy
- Post-surgical pain
- Pain following an amputation
- Abdominal pain
Understanding the conditions treated by your doctor is an important first step in determining whether spinal cord stimulation is right for you. Your doctor will assess if this treatment is suitable and likely to provide significant relief from your chronic pain.
To make this decision, your pain specialist may order imaging tests and psychological screenings. These screenings are often required by insurance companies to rule out conditions like depression or anxiety that could be worsening your pain or impacting the treatment’s effectiveness.
In general, spinal cord stimulation is most beneficial for patients who have not found sufficient relief from medications, more conservative therapies, or previous surgeries.
How effective is spinal cord stimulation (SCS)?
The success of spinal cord stimulation (SCS) largely depends on individual factors and the experience of the doctor performing the procedure.
SCS is often effective in providing significant pain relief for patients with chronic pain conditions. Success rates can vary, but many patients report a reduction in pain of at least 50%, improved quality of life, and decreased reliance on pain medications. Long-term outcomes also depend on proper patient selection and ongoing follow-up care.
For instance, a study published in Pain Practice found that after 12 months of treatment, 76% of patients experienced ≥50% relief of back pain, and 80% had ≥50% relief of leg pain. Patients also reported significant improvements in quality of life 1.
When considering SCS, it’s important to discuss these key factors with your doctor:
- How SCS success is defined (e.g., pain reduction, improved functionality)
- The percentage of patients who experience significant pain relief
- Long-term outcomes for patients with similar conditions
What are the risks and potential complications?
Every medical procedure has risks, which your doctor should discuss with you before treatment. These risks can include:
- Infection: SCS surgery requires a small incision in order to implant the stimulator device. As with any procedure that requires an incision, there is a mild risk of infection at the implant site. Infections are generally easy to identify and can be treated with antibiotics.
- Leads moving or breaking: Although advances in technology have reduced the chances of this happening, it’s still possible that the stimulator leads can shift out of place or break due to the spine’s natural flexibility. If this occurs, an additional procedure may be needed to correct the issue.
- Changes in stimulation or reduced effectiveness: Over time, some patients may experience unwanted changes in how the stimulation feels or a gradual loss of pain relief. If this happens, your pain specialist can help you evaluate the best course of action.
- Device malfunction or battery failure: The pulse generator, which powers the device, has a limited lifespan and may eventually fail or require a battery replacement. Luckily, SCS implants can be removed or replaced via a routine, outpatient procedure.
How long does the battery last and what happens when it needs replacement?
Despite significant technological improvements, spinal cord stimulator batteries do not last forever and eventually need replacement. Understanding battery life helps you plan for future procedures.
Ask your doctor these specific questions:
- What type of battery does the device use?
- How long does the battery typically last?
- What does the replacement surgery involve?
- What are signs that the battery needs replacement?
Some newer devices have rechargeable batteries that last well over a decade. Other devices do not require recharging, but these tend to have a lifespan of five to seven years. These timelines can vary depending on device programming and patient needs.
What is the trial period process and what should I expect?
The first step in getting a spinal cord stimulator is the trial period. During this phase, a temporary device is implanted to see if it effectively reduces your pain.
Using fluoroscopy (a special type of X-ray), the surgeon inserts electrodes into the epidural space of your spine using a specialized introducer device. The placement will depend on where your pain is located, and the surgeon may ask for your input during the procedure to position the electrodes correctly. The battery remains outside your body, usually attached to a belt worn around your waist.
Over the course of about a week, you’ll test how well the device manages your pain. If it reduces your pain by 50% or more, the trial is considered a success, and surgery will be scheduled to implant the generator. If it’s unsuccessful, the wires can be easily removed in clinic without harming the spinal cord or nerves.
Your doctor should explain:
- How long the trial period lasts (usually three to seven days)
- What the temporary device feels like
- How to track your pain levels during the trial
- What activities you can and cannot do during the trial
- How they determine if the trial was successful
Your doctor should provide clear instructions for managing the temporary device and reporting any problems.
FAQs
You should ask your doctor to clearly describe which types of chronic pain conditions they commonly treat with spinal cord stimulation (SCS), and whether your specific diagnosis aligns with those. Typical conditions include failed back surgery syndrome, chronic back pain that has not responded to other therapies, complex regional pain syndrome (CRPS), diabetic neuropathy, peripheral neuropathy, post-surgical pain, pain after an amputation, and even abdominal pain.
Effectiveness of SCS varies depending on individual factors, but many patients experience substantial benefits when treated by an experienced provider. Over 75% of patients report pain reduction of at least 50%, improved quality of life, and a decreased reliance on pain medications. These numbers continue to improve as SCS technology advances.
No medical procedure is without risk, and your doctor should discuss the possible complications of SCS with you. Possible risks can include surgical-site infection, lead migration or breakage, changes or decreases in stimulation effectiveness, and device malfunction or battery failure. These types of complications are rare and SCS is still much safer than more invasive surgeries. But you should still ask your provider how to monitor for complications and what steps they would take in the unlikely event something goes wrong.
Spinal cord stimulators use a battery-powered pulse generator, and over time, that battery will need to be replaced. Ask your physician what type of battery your chosen device uses, how long it typically lasts, and what replacement involves. For example, newer devices may have rechargeable batteries lasting more than a decade, whereas non-rechargeable versions may last 5–7 years, depending on how they are programmed and used. You should also understand the signs that indicate the battery is nearing its end of life, as well as the surgical process for replacing it.
Replacing a spinal cord stimulator battery is a routine, minimally invasive procedure. If replacement is necessary, the procedure is performed in an outpatient setting in essentially the same way as the original implant. The old device is removed, and a new one is implanted in its place, usually without having to move the original leads.
Before a permanent spinal stimulator is implanted, patients generally go through a trial period where a temporary device is placed to test how well stimulation relieves their pain. During this trial, electrodes are placed via fluoroscopy into the epidural space of the spine, while the battery remains outside the body (often connected to a belt you wear). The trial typically lasts 3-7 days. Your doctor should explain how you should track your pain levels during that time, which activities are allowed or restricted, and how they will decide whether your trial is a “success.” They should also give you clear instructions for caring for the temporary device and reporting any problems during the trial.
Spinal cord stimulation near you at the Twin Cities Pain Clinic in Minnesota
Choosing the right spinal cord stimulator doctor is an important decision in your pain management journey. These five questions help you evaluate potential doctors and make an informed choice about your treatment.
At Twin Cities Pain Clinic, our experienced pain management specialists understand how chronic pain affects your life. We provide comprehensive evaluations and personalized pain treatment plans that may include spinal cord stimulation. Our team is dedicated to helping you find relief and return to the activities you love.
If you are considering spinal cord stimulation, contact Twin Cities Pain Clinic at 952-260-1381 or schedule an appointment online to discuss whether this treatment option is right for you.
The contents of this article are intended for informational and educational purposes only and are not intended as a substitute for professional medical advice, diagnosis or treatment. Always consult with a physician or other qualified healthcare provider before engaging in any action or decision-making based on the content of this article. Never disregard or delay seeking professional medical advice or treatment because of the content of this article or any other content on the Twin Cities Pain Clinic website. Reliance on any information conveyed on the Twin Cities Pain Clinic website without direct consultation with a healthcare professional is solely at your own risk.
Sources:
- Kallewaard JW, Gültuna I, Hoffmann V, et al. 10 kHz Spinal Cord Stimulation for the Treatment of Failed Back Surgery Syndrome with Predominant Leg Pain: Results from a Prospective Study in Patients from the Dutch Healthcare System. Pain Practice. 2020;21(5):490-500. doi:10.1111/papr.12973
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