Chronic pain is a long pain which will be there even after the usual recovery period. It can also accompany a chronic health condition. The pain is not protective and it is not because of an ongoing injury. It is mostly referred as pathological and is therefore treated not like a symptom but a condition. Chronic pain will prevent people from working, participating in physical activity, eating properly, or enjoying life.
Spinal cord stimulation (SCS) is a pain relief technique which will deliver a low voltage electric current continuously to the spinal cord. This is done to block the sensation or feeling of pain. SCS is the most commonly used implantable neurostimulation technology. It can manage the pain syndromes. Around 50, 000 neurostimulators are implanted worldwide yearly.
SCS is a widely accepted FDA approved medical treatment for chronic pain of the limbs such as legs, back and arms, and the trunk. SCS device is of three types:
- The conventional system requires less effort for maintenance on the patient’s part. A minor surgical procedure is required to replace the power source when it runs out.
- Radiofrequency systems are designed to sustain therapy over long periods of time at the highest output level. The RF system has high power capabilities because of which it can be used for the most challenging cases in which there is multi extremity pain, and for complex cases. With this type of system, the patient has to wear an external power source in order to activate stimulation.
- Rechargeable systems are the latest type of SCS device. Here the patient has the duty to recharge the power when it runs low. The rechargeable system will last longer than the conventional system. A minor surgical procedure may be needed to replace the lower power source if the time between the recharges becomes impractical.
Patients who are considered for SCS should meet the following conditions:
- Pain is not linked with malignancy
- The patient is not responding well to conservative treatment for a minimum duration of six months.
- If revision surgery is not an option or it would have a low chance of success.
- There are no major psychiatric disorders, somatization included
- No pacemaker or any other medical contraindications.
- There is no related litigation
- You are ready to stop inappropriate drug use prior to implantation
- You should give informed consent for the procedure.
The implantation of the stimulator is done by a sedative or a local anesthetic. Your doctor will insert a trial stimulator through the skin in order to give the treatment a trial run. If the trial is successful, then your doctor will implant a permanent stimulator. After the procedure is complete, you and your doctor will have to determine the best pulse strength. You will then be told how you are supposed to use the stimulator at home. The typical schedule for spinal cord stimulation is to use it for 1 to 2 hours or 3 to 4 times a day.