Spinal Cord Stimulation – We’re Still Not Sure Why It Works

Medical science is capable of doing some truly amazing things. Ironically, the medical community does not always understand why certain things work. Take spinal cord stimulation (SCS), for example. Plenty of patients report experiencing dramatic pain relief after undergoing an SCS procedure. Yet researchers still do not understand the mechanism behind that relief.

Lone Star Pain Medicine is a Weatherford, TX chronic pain practice that often recommends SCS for neuropathic pain. They say that the mechanism behind SCS may be its ability to interrupt pain signals being sent to the brain. That comports with an explanation offered by John Hopkins Medicine.

John Hopkins says that SCS produces a condition known as paresthesia. This condition occurs when pain sensations are replaced by tingling sensations. The tingling may be enough to fool the brain into missing pain signals. Though science does not yet have all the answers, the one thing we know for sure is that SCS patients testify that the procedure works.

Pre-Surgical Testing

SCS is accomplished by implanting a small electrical appliance in a patient’s lower back. However, doctors will generally recommend a test procedure prior to surgery. That way, surgery can be avoided if the test procedure demonstrates SCS will not work for that patient.

The key to both the test procedure and the surgery is the stimulator device itself. It is a pretty simple device consisting of a battery pack, a small electrical generator, and electrodes. The electrodes are essentially insulated wires that are inserted into the epidural space around the spinal cord.

A test procedure generally results in constant electrical stimulation of the spinal column. Should the test prove successful, permanent implantation often gives a patient the opportunity to control stimulation as needed. This would be accomplished with a remote control. When the patient begins to feel pain, they simply turn the device on. They can turn it back off when the pain subsides.

The Surgical Procedure

Generally speaking, doctors like to test SCS for one week before moving ahead with surgery. The surgical procedure itself is an outpatient procedure that requires an hour or two to complete. As for the SCS device, it is generally implanted somewhere in the lower back, near the buttocks. The device is small enough that it should not hinder normal activity in most people.

Permanent implantation is advised only for patients with chronic pain that has not been effectively addressed with less invasive means. SCS is an appropriate treatment for:

  • chronic back pain
  • post-surgical pain
  • spinal cord injuries
  • neuropathic pain
  • complex regional pain syndrome
  • peripheral vascular pain.

There may be other conditions for which a doctor may recommend SCS. These include things like chronic angina and arachnoiditis. In every case, there is one thing in common: doctors are careful to thoroughly discuss the procedure and its implications before moving ahead with it.

Possible Complications

In closing, it is important to know that SCS implantation is an invasive surgical procedure. As with every surgical procedure, complications are always a possibility. The most common is infection. It can occur any time within the first eight weeks following surgery.

Other complications include bleeding, device migration, and spinal trauma. Doctors should discuss these complications and their likelihood prior to recommending SCS.

Despite not fully understanding its pain-relieving mechanisms, SCS is a therapy that has provided pain relief for countless numbers of patients who have found relief and no other way. SCS is yet another example of the amazing things modern medical science can do. It is also a reminder that medical science doesn’t have all the answers.

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