How a Spinal Cord Stimulation Trial Works

How a Spinal Cord Stimulation Trial Works

spinal cord stimulator is not a first-step treatment for back pain. But if you have chronic back pain for three months or longer or failed back surgery, Dr. Michael Esposito, our physician at the Interventional Spine & Pain Institute, may recommend a spinal cord stimulator to help you manage pain. It may also be recommended to treat complex regional pain syndrome (CRPS), reflex sympathetic dystrophy (RSD), causalgia, and chronic post surgical pain, which are pain syndromes that occur after crush injuries, nerve injuries, or surgery. 

Dr. Esposito implants this device into your body to deliver electrical energy that disrupts pain signals. The stimulator consists of thin wires and a generator. Using a remote control that’s outside of your body, you direct electrical impulses that relieve your pain. 

Before Dr. Esposito implants the stimulator, he has you go through a trial run (like a test drive) using the device. The trial lasts about 5-7 days, after which you report back about your pain and how the stimulator worked for you.

If you’re scheduled for a spinal cord stimulation trial, here’s the process and what you can expect. 

Implanting of the electrodes

Dr. Esposito inserts the wires, or electrodes, of the spinal cord stimulator through a needle for the trial period so they can target the point of pain and alter how your brain perceives this pain. This process is done at the office. 

Dr. Esposito applies local anesthesia to the injection site. You may also undergo light sedation. Some patients require a small skin nick in the lower back for placement.

A special type of X-ray, called fluoroscopy, guides a hollow needle into the area around the spinal canal — the epidural space. This needle contains the electrodes. 

Exactly where Dr. Esposito places the electrodes depends on the nature and location of your pain. He communicates with you when placing the wires to make sure they cover all areas of pain. 

Connecting to the generator

The wires connect to a generator that sits outside your body for the trial period — you usually wear it in a belt around your waist. Alternatively, the doctor tapes the generator to your back. If the trial is successful, we schedule surgery to permanently implant the device beneath your skin.

Recovery before heading home

Before you leave the office to begin your trial, we make sure your vital signs return to normal. You’re given the hand-held controller that you adjust to send stimulation through the electrodes that disrupts pain. Dr. Esposito programs the controller according to earlier feedback about your pain levels and how the stimulator affects them.

We make sure you fully understand how to use the controller. It offers a range of adjustments that include intensity and duration of stimulation.

Expect to have some soreness in your back at the site of the needle insertion or incision. This discomfort lasts just a few days. Report any significant pain or signs of infection to our office.

Tracking your pain levels

Dr. Esposito requests that you track your pain levels and the effects of stimulation at different times of the day. If you don’t notice changes in your pain levels, contact our office right away so we can reprogram the device.

A successful spinal cord stimulation trial relieves your pain by 50% or more. The procedure doesn’t work in about 30% of cases, but that means 70% of people with a stimulator find a great deal of relief. 

If the trial is a success, we schedule a minor outpatient surgery to permanently implant the device. If the trial is unsuccessful, it’s easy for Dr. Esposito to remove the wires.

Find out more about spinal cord stimulation by setting up an appointment at our office in Vero Beach, Florida. Call Interventional Spine & Pain Institute today or request an appointment online.

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