A solution to persistent pain? Let's learn about the Spinal Cord Stimulator

Do you suffer from severe, persistent pain that doesn't go away despite all the medication and treatment? We know how difficult it is to live with this kind of pain, especially in the back, legs, and arms. So today we are going to talk about a special medical device that can help control this kind of severe pain.

Simply put, what is this spinal cord stimulator?

A spinal cord stimulator is a small medical device that your doctor can surgically implant inside your body. It is used to control severe, long-term pain. It is also used as a good alternative to strong painkillers, such as opioids, which can sometimes be addictive.

How does this device reduce pain?

To understand how this works, you need to have a little idea about pain and our nervous system.

What is pain?

Pain is usually a protective mechanism. It lets us know when you're injured or something is going to happen. Pain is also a major symptom of many diseases.

However, pain does not always provide us with protection. Some medical conditions can cause unbearable pain, or it can be a constant pain that never goes away. We call this chronic pain . Living with this kind of pain can make it difficult to sleep or even do anything useful. Over time, this can also have a significant impact on your mental health.

Function of the nervous system

Think of your nervous system as a network of telephone wires that runs throughout your body. It's what carries information back and forth between your brain and the rest of your body. Pain is like a "call" coming through this telephone line to your brain.

This method, called neuromodulation, uses a very fine electrical current to stimulate certain nerve fibers in your spinal cord. In other words, it's like making another "call" to the same phone line that's receiving the pain "call" and making the line busy . This blocks the pain signal from reaching the brain. This is how the pain sensation is reduced.

Who needs this treatment the most?

This treatment is usually used when other treatments, such as pills, injections, and physical therapy, have not been successful. Although these conditions are more common among adults, young children may sometimes need this treatment as well.

The table below shows some of the main conditions treated with this device.

In addition, research is underway to see if this method can be useful for other conditions, such as chest pain (angina), spinal cord injuries, and nerve pain after herpes zoster (shingles).

What happens before the surgery?

This is not a first-line treatment. This means that it is considered when all other treatments have failed. Before the surgery, you will need to do several things, such as blood tests and scans, to see if you are suitable for it.

Also, you will have to see several specialists.

• Neurologist: Identify the exact condition causing your pain.
• Pain Management Specialist: Make sure other treatments have not worked.
• Neurosurgeon: He is the one who performs the surgery to implant this device.
• Psychiatrist/Psychologist: Chronic pain can have a major impact on your mental health, so it's important to pay attention to your mental health as well.
• Anesthesiologist: Talk about it because the surgery is performed under anesthesia.

Once everything is in order, you will receive instructions on how to prepare for the surgery. This includes things like telling the doctor about the medications you are taking and fasting before the surgery.

What happens during the surgery?

This process usually occurs in two stages. The first is a "trial" process. If that is successful, the second stage is when the device (pulse generator/battery) is permanently implanted inside the body.

1. Trial Procedure

In this procedure, you are given anesthesia to put you into a light sleep. Then, using a technique similar to X-ray (fluoroscopy), a needle is inserted through the skin into the correct place in your spine (the epidural space). The other end of the electrode is brought out of the skin and connected to a temporary battery on the outside.

This trial lasts for a few days to a week or two. If your pain is reduced by more than 50% during this time, the trial is considered successful. If so, the next step is surgery to implant a permanent device.

2. Permanent device implantation (Implantation Surgery)

This procedure is performed under general anesthesia. Here, permanent electrodes are placed in the same place as in the experiment. Then, a small space is created under the skin and a battery (pulse generator) is placed. This battery is usually placed in a place that you can easily control, for example, on the side of the abdomen or in the buttocks.

Some batteries can be turned on/off with a remote. Some can be charged. Your doctor will explain all of this to you.

What are the advantages and disadvantages of this treatment?

Like any medical method, this one has both advantages and disadvantages.

When should you see a doctor urgently?

You will be given follow-up appointments after the surgery. Be sure to attend those appointments. However, if you experience any of the following warning signs , you should go to the hospital or Emergency Department (ETU) immediately .

• A persistent headache that occurs when standing or sitting and goes away when lying down: This may be a sign of a cerebrospinal fluid (CSF) leak.
• Signs of infection at the surgical site: redness, swelling, pain, or discharge of a foul-smelling fluid from the wound.
• Sudden onset of numbness, loss of sensation, or muscle weakness in the lower body: This may be a sign of spinal cord damage caused by vertical movement from the electrode site.
• Symptoms of sepsis: High fever, chills, difficulty breathing, and confusion. This is a life-threatening emergency.

Typically, it takes about 4-6 weeks for the permanent device to fully heal and return to normal activities. Your doctor will advise you to avoid heavy lifting and strenuous bending during this time.

Chronic Pain, Back Pain, Spinal Cord Stimulator, Nerve Pain, Surgery, Pain Management