How Does a Spinal Cord Stimulation Trial Work?

Pain is usually a critical protective process for the body. A sensory nerve sending out a pain signal alerts the brain to an acute injury or illness so it can produce the necessary healing response. Once the injury has healed or the illness has run its course, the nerve stops the signal and/or the brain stops responding, and everything returns to normal. At least, it’s supposed to.

However, sometimes pain turns chronic, lasting more than three months. There may be damage that hasn’t healed or healed correctly, or your brain may be misinterpreting the nerve’s signals and thinking you’re still in pain, even when there’s no painful stimulus.

This constant stimulation strengthens the faulty pathway that signals pain, reinforcing your perception of pain. This connection can increase sensation (hyperalgesia) or cause your nervous system to send pain signals for things that shouldn’t hurt (allodynia).

At Interventional Pain Center in Legacy Office Park, Norman, Oklahoma, Dr. James Stephens understands the impact pain can have on your life. When all else fails, he offers several interventional pain treatments, including spinal cord stimulation (SCS). Here’s what you need to know about SCS and how the trial phase works.

Your spine in a nutshell

Your spine contains 24 bony vertebrae hooked together in a chain by facet joints and interspersed with intervertebral discs that cushion the bones and absorb shock from movement. It extends from the base of your skull to your tailbone, with the central core of the column essentially a hollow tube called the spinal canal.

The spinal cord runs through this tube, with extensions of the nerves exiting at the foramen (openings) between the vertebrae. If anything puts pressure on the nerves or the sensitive nerve roots inside the canal, the result is pain that can travel along the nerve’s path.

What is spinal cord stimulation?

SCS (aka neuromodulation) uses a mild electrical current to stimulate specific nerve fibers in your spinal cord. Since the current “occupies” the nerves, they can’t respond to the pain signals, and your brain never receives the “pain” message.

SCS is not a first-line treatment; it’s used when all other conservative options have been tried and failed.

Conditions that respond well to SCS include:

• Lower back pain
• Complex regional pain syndrome (CRPS)
• Persistent spinal pain syndrome (PSPS), previously known as failed back surgery syndrome
• Diabetes-related neuropathy
• Neuropathic pain (nerve malfunctions)

If Dr. Stephens decides you’re a good candidate for the treatment, he first conducts a trial to ensure you’ll benefit from it. Here’s how it works.

The SCS trial involves inserting one or more electrical leads with conductive tips into the epidural space between the dura mater (the outer membrane that surrounds the spinal cord) and the ligaments on the inner part of your spine. The leads connect to a pulse generator that produces the electrical current that stimulates the spinal cord.

To insert the leads, Dr. Stephens makes a small incision in your skin and maneuvers a special needle using fluoroscopy (X-ray video) to help him visualize the internal structures. Once the needle reaches the epidural space, he threads the temporary lead(s) into position, then removes the needle, leaving part of the lead outside your skin.

He secures the external end of the lead to your skin and connects it to a pulse generator, which he also attaches to your skin. Then he programs the device and starts the trial, which generally lasts about a week. If you experience a 50% decrease in your pain level, the trial is deemed successful, and Dr. Stephens implants the generator in your back. You can adjust the device through an external remote control.

Are you dealing with back pain that persists no matter what you do? Does the pain travel into your arm or leg? Spinal cord stimulation might be the answer. To learn more or to set up a consultation with Dr. Stephens, call Interventional Pain Center at 405-759-8407, or use our online booking tool today.