What to Expect During Your Spinal Cord Stimulation Trial

Your body uses pain as a critical protective process. A sensory nerve sends out a pain signal that alerts the brain to an acute injury or illness so it can produce the necessary healing response. Once the body has healed, the nerve stops the signal and/or the brain stops responding, and everything returns to normal. At least, that’s what’s supposed to happen.

However, sometimes pain turns chronic, defined as lasting three months or more. The reason may be due to damage that hasn’t healed or healed correctly, or your brain may be misinterpreting the nerve’s signals, concluding you’re still in pain even in the absence of a painful stimulus.

The constant production of pain signals along the length of the nerve strengthens the faulty pathway that signals pain, which reinforces your perception of pain. This connection can magnify sensation (hyperalgesia) or cause your nervous system to send pain signals when nothing actually hurts (allodynia).

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

Your spine’s building blocks

Your spine contains 24 bony vertebrae linked into a chain by facet joints, interspersed with intervertebral discs that cushion the bones and absorb shock from movement. The spine reaches from the base of your skull to your tailbone; the central core of the column is essentially a hollow tube called the spinal canal.

The spinal cord runs through the spinal canal, with extensions of the nerves exiting at openings (foramen) between the vertebrae. If anything applies pressure to the nerves or the sensitive nerve roots inside the canal, you experience pain that can travel anywhere along the nerve’s path.

What is spinal cord stimulation?

SCS (also called neuromodulation) uses a mild electrical current to stimulate specific nerve fibers in the spinal cord. Since the current occupies the nerves’ communication pathways, your brain fails to receive the pain message, and the nerves can’t send any pain signals.

SCS is not a first-line treatment; we use it when all other conservative options have 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 SCS, he first conducts a trial to ensure you’ll benefit from the procedure. Here’s how it works.

The SCS trial

During the SCS trial, Dr. Stephens inserts one or more electrical leads with conductive tips into the epidural space. This space lies between the dura mater (the outer membrane surrounding the spinal cord) and the ligaments on the inner part of your spine. The leads all connect to a pulse generator that produces the electrical current that stimulates the spinal cord. 

While we implant the permanent generator in the buttocks or abdomen, you wear it outside your body during the trial.

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

He secures the external end of the lead to your skin and connects it to the pulse generator. Then, he programs the device and starts the trial, which lasts about a week. 

If you see a 50% decrease in your pain level during that time, the trial is deemed successful, and Dr. Stephens implants the generator in your back. You adjust the device through an external remote control.

If you’re dealing with back pain that persists no matter what you do, and the pain travels 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.