Spinal Cord Stimulation/Neuromodulation

Spinal Cord Stimulation (SCS) for Peripheral Neuropathy: Detailed Explanation

What Is Spinal Cord Stimulation?

Spinal Cord Stimulation (SCS) is a minimally invasive, implantable device-based therapy used to manage chronic pain by delivering mild electrical impulses to the spinal cord. It is commonly used to treat peripheral neuropathy, a condition characterized by nerve damage that causes chronic pain, tingling, numbness, or weakness—especially in the hands, feet, arms, or legs.

SCS helps disrupt pain signals before they reach the brain, providing relief without the need for high doses of pain medication.

What Is Peripheral Neuropathy?

Peripheral neuropathy occurs when peripheral nerves (those outside the brain and spinal cord) become damaged. This condition affects the communication between the brain, spinal cord, and the rest of the body.

Common Causes of Peripheral Neuropathy:

  • Diabetes (Diabetic Neuropathy)
  • Chemotherapy-induced nerve damage
  • Nerve compression (such as herniated discs)
  • Autoimmune diseases (e.g., lupus, rheumatoid arthritis)
  • Alcohol abuse
  • Infections (e.g., shingles, HIV)
  • Trauma or injury

Symptoms of Peripheral Neuropathy

  • Burning or stabbing pain
  • Tingling or numbness (often in the hands or feet)
  • Muscle weakness
  • Sensitivity to touch
  • Loss of coordination or balance
  • Pain that worsens at night

How Does Spinal Cord Stimulation Work?

SCS works by delivering low-level electrical impulses to the spinal cord through thin wires (electrodes) placed near the spinal cord. These impulses interfere with pain signals traveling to the brain, reducing the perception of pain.

How Is the Procedure Performed?

  1. Pre-Procedure Evaluation:
    • Detailed medical history and physical examination.
    • Imaging tests (MRI, CT) to assess spinal anatomy.
    • Psychological evaluation to ensure the patient is a good candidate.
  2. Trial Phase:
    • A temporary electrode is placed under the skin near the spinal cord through a small incision.
    • The device is connected to an external battery.
    • The patient tries the stimulator for 5-7 days to assess pain relief.
    • If pain relief is satisfactory (50% or greater reduction), the permanent device can be implanted.
  3. Permanent Implantation:
    • Performed under local anesthesia with mild sedation.
    • A small incision is made in the back to place the permanent electrodes along the spinal cord.
    • A small generator (battery) is implanted under the skin near the buttock or abdomen.
    • The device is programmed to deliver customized electrical impulses.

Who Is a Candidate for Spinal Cord Stimulation?

SCS is recommended for patients with:

  • Chronic peripheral neuropathy pain that hasn’t responded to medications or physical therapy
  • Pain lasting more than 6 months
  • Pain not relieved by other treatments
  • Failed back surgery syndrome (FBSS)
  • Diabetic peripheral neuropathy
  • Complex regional pain syndrome (CRPS)

Benefits of Spinal Cord Stimulation

  • Non-opioid pain relief
  • Adjustable, customizable pain control
  • Minimally invasive procedure
  • Reversible (device can be removed if ineffective)
  • Improved quality of life
  • Reduction in pain medication use

Risks and Complications

While generally safe, possible risks include:

  • Infection at the implantation site
  • Bleeding or nerve damage
  • Device malfunction
  • Lead migration (movement of the electrode)
  • Pain at the incision site
  • Failure to relieve pain

Recovery and Follow-Up

  • Patients typically return home the same day or the next day.
  • Most people resume light activities within 1-2 weeks.
  • The device can be adjusted or reprogrammed based on the patient’s needs.
  • Regular follow-ups are needed to monitor pain relief and device performance.

Success Rate

Studies show that 50-70% of patients experience significant pain relief with spinal cord stimulation. The procedure is particularly effective in managing neuropathic pain that hasn’t responded to other treatments.

How Does SCS Compare to Other Treatments?

Treatment Invasiveness Recovery Time Pain Relief Reversible Success Rate
Medications Non-invasive None Temporary Yes Varies
Physical Therapy Non-invasive None Temporary Yes Varies
Nerve Blocks Minimally invasive 1-2 days Temporary Yes 40-60%
Spinal Cord Stimulation Minimally invasive 1-2 weeks Long-lasting Yes 50-70%

Conclusion

Spinal Cord Stimulation (SCS) is a proven, minimally invasive treatment option for managing chronic peripheral neuropathy pain. It offers significant pain relief without the side effects of opioid medications or major surgery. By blocking pain signals before they reach the brain, SCS helps patients regain mobility, improve quality of life, and reduce reliance on medications.

If you’re considering spinal cord stimulation, consult with an interventional radiologist to determine if you’re a suitable candidate.

Would you like help finding SCS specialists near you or a step-by-step infographic of the procedure?