Back pain is something that is beyond words to describe, isn't it? Sometimes, even after taking medicine, exercising regularly, and continuing physiotherapy , this severe pain does not subside. There are times when living with this pain for years can be a life-threatening experience. So, today we are talking about an advanced treatment that brings new hope to those who have failed in this way, like all other treatments.
Simply put, what is Spinal Cord Stimulation?
This name may sound like a big, complicated thing. But let's keep it simple. Imagine that there are "telephone wires" that carry pain from your spine to your brain. These wires are the nerves that run along your spinal cord. When there is a problem with your spine, these nerves keep sending signals to your brain saying "pain, pain."
This treatment, called Spinal Cord Stimulation (SCS) , works by interrupting the pain signals from reaching the brain. It's like creating a traffic jam on the road, blocking the vehicles carrying the pain signals from reaching the brain.
This uses a very small, weak electrical current. When this electrical current is given to the spinal cord, another signal is sent to the brain instead of the pain signal. Some people feel this as a very subtle, pleasant sensation, like a tingling sensation. Some of the latest technology devices can even eliminate pain without any feeling.
Simply put, SCS is a pain blocker that "masks" pain, or stops pain signals from reaching the brain.
How do you know if this treatment is right for you?
This is a very important question. SCS treatment is not suitable for everyone with back pain. Doctors usually recommend this treatment only to patients who meet certain conditions.
- If other treatments have failed: You have already tried medications, injections, and physical therapy for at least 6 months and none of them have provided sufficient pain relief.
- If pain persists after surgery: Sometimes pain can persist even after back surgery. We call this condition Failed Back Surgery Syndrome (FBSS). SCS is a good option for people like this.
- If surgery is not possible: If your doctor has decided that surgery is not appropriate for your back pain.
- For other nerve pain: This method is also used for persistent nerve pain, such as diabetic neuropathy or Complex Regional Pain Syndrome (CRPS) caused by other injuries.
Before you undergo this treatment, your doctor will examine you thoroughly. It is also very important to see how mentally prepared you are for this. Because this is an implantable device, you need to have a good understanding of it and a good mental state.
How is this device inserted into the body?
This is a two-step process. The permanent device is not installed all at once.
First Step: Trial Period
This is the most important part. Before the permanent device is implanted, a trial is done to see if it really works for your body and reduces pain.
1. Electrode insertion: You will be numbed (local anesthesia), and a thin wire-like electrode will be inserted near your spine using a very fine needle through the back of your neck. This does not require a large incision.
2. Connecting to an external device: The electrode is connected to a small stimulator that is outside your body, usually worn on a belt.
3. Home test: You will be allowed to go home and do your normal activities for about 5 to 7 days. You can increase or decrease the stimulation with a small remote control to see if your pain is relieved.
If your pain is reduced by more than 50% during this trial period, it means that this treatment is successful for you. That's when the doctor will decide to implant the permanent device.
Step Two: Permanent Implantation
If the experiment is successful, you will undergo a minor operation.
1. Electrodes are permanently implanted near the spinal cord.
2. The battery that generates the electrical signals, or Pulse Generator , is implanted through a small incision under the skin of the upper abdomen or buttocks. This is a small device about the size of a matchbox.
3. All of this is hidden under the skin, so it's not visible. You can turn it on/off and change the stimulation level whenever you want with the remote control you get.
Are there different types of these devices?
Yes, there are several main types of Pulse Generators. Your doctor will help you choose the one that best suits your lifestyle and needs.
| Device type | Description and advantages/disadvantages |
|---|---|
| Rechargeable Systems | Pros: The battery lasts for several years (e.g. 8-10). It can be charged with a special charger that is worn on the skin. Disadvantages: You have to remember to charge it on time. |
| Non-Rechargeable Systems | Pros: No need to charge, so maintenance is low. Cons: The battery will run out after a few years (e.g. 3-5). After that, you will have to undergo another minor surgery to replace the battery. |
| Radio-Frequency Systems | These are a fairly old technology that is not widely used anymore. The battery has to be worn outside the body. |
As with any surgery, there are risks associated with this treatment. For example, there may be an infection at the surgical site, the electrode may move, or the device may malfunction. However, these are very rare. Your medical team will take every precaution to minimize these risks.
Take-Home Message
- Spinal Cord Stimulation (SCS) is an advanced treatment method used for chronic back and nerve pain where other treatments, such as medication and physical therapy, have failed.
- This works by blocking pain signals from reaching the brain. A small electronic device is implanted in the body.
- This treatment is not suitable for everyone. Whether it is right for you will only be determined after a thorough examination by a specialist.
- Before implanting a permanent device, a trial period is mandatory. Only if it is successful will the permanent device be implanted.
- If you too have this kind of persistent, unbearable pain, don't be afraid to talk to your doctor about these modern treatment options. Don't give up hope.
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