What Is Spinal Cord Stimulation?
Spinal cord stimulation (SCS) is one of the most significant advances in chronic pain management over the past two decades. As a triple board-certified pain management specialist in Hoffman Estates, Illinois, I have implanted hundreds of spinal cord stimulator systems and have seen firsthand how this technology can transform the lives of patients who have exhausted other treatment options. If you’re living with chronic pain that hasn’t responded to medications, injections, physical therapy, or even surgery, spinal cord stimulation may offer the relief you’ve been searching for.
How Spinal Cord Stimulation Works
A spinal cord stimulator is a small device — similar in size to a pacemaker — that delivers mild electrical impulses to the spinal cord. These impulses interrupt pain signals traveling from the nerves to the brain, effectively replacing the sensation of pain with a mild tingling or, with newer technologies, no sensation at all. The system consists of a small pulse generator (battery) that is implanted under the skin, typically in the buttock or abdomen area, thin flexible leads (wires) that are placed in the epidural space near the spinal cord, and a handheld remote control that allows you to adjust stimulation settings. The beauty of this technology is that it can be tested before any permanent implant is placed — something I always recommend and will explain in detail below.
Who Is a Candidate for Spinal Cord Stimulation?
Not every chronic pain patient is a candidate for SCS. In my practice, I typically consider spinal cord stimulation for patients who meet several criteria. The ideal candidate has chronic pain that has lasted at least 3 to 6 months and has not responded adequately to conservative treatments including medications, physical therapy, and injections. The pain should be neuropathic in nature — meaning it involves nerve damage or dysfunction rather than purely mechanical or inflammatory causes. Common conditions that respond well to SCS include failed back surgery syndrome (persistent pain after one or more spinal surgeries), chronic radiculopathy (nerve root pain radiating into the arms or legs), complex regional pain syndrome (CRPS), peripheral neuropathy, and certain types of refractory angina and peripheral vascular disease pain.
Equally important, candidates should not have untreated psychological conditions that could interfere with treatment success, active infections, or bleeding disorders that would make surgery unsafe. I evaluate each patient thoroughly before recommending a trial.
The Trial Period: Try Before You Commit
One of the unique advantages of spinal cord stimulation is the trial period. Before any permanent device is implanted, I place temporary leads through a minimally invasive outpatient procedure. You then live with the trial system for approximately 5 to 7 days, going about your normal daily activities to assess how well the stimulation controls your pain. During this time, you’ll track your pain levels, medication use, activity levels, and sleep quality. A trial is considered successful if you experience at least a 50 percent reduction in pain — though many of my patients report significantly greater improvement. If the trial is successful, we proceed with the permanent implant. If it’s not, the temporary leads are simply removed with no lasting effects. This try-before-you-buy approach gives patients tremendous confidence in the decision to move forward.
Modern SCS Technologies
Spinal cord stimulation has evolved dramatically. Today’s systems offer multiple stimulation waveforms and programming options that can be tailored to each patient’s specific pain pattern. High-frequency stimulation (HF10) delivers stimulation at 10,000 Hz, providing pain relief without the tingling sensation associated with traditional SCS. Burst stimulation mimics natural nerve firing patterns and has shown particular effectiveness for certain pain conditions. Traditional low-frequency stimulation remains effective and well-studied, with decades of clinical evidence. Some newer platforms offer closed-loop technology that automatically adjusts stimulation based on real-time measurements of spinal cord nerve activity, maintaining consistent pain relief as you move throughout the day. I stay current with all major device platforms so I can match each patient with the technology best suited to their specific condition.
What to Expect During and After Implantation
The permanent implant procedure is performed under sedation or light general anesthesia and typically takes 1 to 2 hours. Most patients go home the same day or after one night of observation. Recovery involves limiting bending, lifting, and twisting for approximately 4 to 6 weeks while the leads stabilize in position. Most patients return to desk work within 1 to 2 weeks and to more physical activities within 6 to 8 weeks. After recovery, I work closely with each patient to optimize their stimulation settings through a series of programming sessions. Finding the ideal combination of settings is a collaborative process, and I encourage patients to communicate openly about what’s working and what can be improved.
Results and Expectations
Clinical research consistently shows that 50 to 70 percent of carefully selected patients achieve significant long-term pain relief with spinal cord stimulation. Many patients are able to reduce or eliminate pain medications, return to activities they had given up, improve their sleep quality, and experience meaningful improvements in overall quality of life. It’s important to have realistic expectations — SCS is designed to reduce pain to a manageable level, not necessarily eliminate it completely. But for patients who have been living with severe, debilitating pain that hasn’t responded to other treatments, even a 50 to 70 percent reduction can be life-changing.
Schedule a Consultation
If you’re living with chronic pain in the Hoffman Estates, Schaumburg, Arlington Heights, Palatine, or greater Chicago area and want to learn whether spinal cord stimulation might be right for you, I welcome the opportunity to evaluate your case.
Call (847) 981-3630 to schedule a consultation, or visit keithschmidtmd.com for more information about our practice and the full range of treatments we offer.
Keith Schmidt, MD, is a triple board-certified pain management specialist at 1555 Barrington Road DOB 3, Suite 2400, Hoffman Estates, IL 60169.