A lot of people have questions about spinal cord stimulation (SCS) and whether it can help them find relief. You’ve been dealing with chronic pain for years, you’ve tried injections and surgery, and you’re looking for more options. These 9 common questions can help you determine if SCS is right for you.
Is SCS covered by insurance?
The good news is spinal cord stimulation (SCS) is covered by most major health insurers including Medicare, commercial payers, and most workers’ compensation programs. Medicaid coverage for SCS varies based on the state and it is recommended that you contact your state’s medicaid office.
Many physicians offer out-of-pocket discounts for patients who do not have insurance but would still like to pursue treatment. Generally, the out-of-pocket cost is significantly lower for patients who do not have insurance.
Does SCS really work?
A study called, “Predictors of spinal cord stimulation success” published in 2015 showed that spinal cord stimulation led to meaningful, statistically significant pain relief in 50-70% of well-selected patients. A study in 2016 entitled, “Patient Outcomes and Spinal Cord Stimulation” showed that 84.3% of patients were satisfied with their spinal cord implant due to improved pain scores.
It is important to remember that there is no silver bullet for patients in chronic pain, and multimodal treatment is almost always more effective than one treatment alone. Modulating pain signals through spinal cord stimulation is only one part of the treatment plan. Patients who incorporate mental therapy and physical therapy into their treatment plan, in conjunction with spinal cord stimulation, have the best long-term outcomes.
What are the risks and benefits of SCS?
Occasionally patients experience device complications, such as a displaced lead, internally fractured electrode, or device malfunction. Major complications, however, are rare. Complication rates are lower when procedures are performed by an experienced practitioner. The medical problems most often seen are bleeding at the site of the implant, or infection. In such instances, removal of the device and antibiotic treatment are generally required. Infection rates can be as low as 1%, but may rise to 4% in some centers.
The benefit of spinal cord stimulation is the ability to take back some control of your life. Many patients say that pain has significantly impacted their lives because they can no longer participate in simple activities like cooking, cleaning, or walking. Spinal cord stimulation has been shown to result in meaningful pain relief for 50-70% percent of well-selected patients (1).
How long does it take to recover?
Full recovery after spinal cord stimulation usually takes somewhere between 6 to 8 weeks. By 6 to 8 weeks the body has had time to heal the small incision where the spinal cord stimulator is inserted and has had time to fix the stimulator leads into place. An in-depth discussion about spinal cord stimulation implantation can be found here.
During the healing process, you are able to carry out activities; however, don’t over do it. In the first two weeks after the procedure, it’s important to refrain from activities that require lifting objects weighing over 10 pounds, and doing physical activities that require twisting, bending, or climbing.
Who is SCS good for?
You can take our eligibility quiz to determine if you are a candidate for spinal cord stimulation. SCS is best for patients who suffer from:
- Chronic pain after back surgery termed “failed back surgery syndrome.”
Chronic pain after surgery is defined as pain that has not resolved 6 months after surgery.
- Chronic pain that has not responded to other treatments.
Chronic pain is defined as pain that has been present for longer than 4 to 6 months and has failed to resolve with other treatments like medication management, injections, and physical therapy.
- Patients who suffer from chronic pain that radiates from the back into one or both of the legs.
Patients that have radiating pain–or “radicular pain,” commonly known as “sciatica”–have a particularly high chance for treatment success.
Other conditions that can be successfully treated with spinal cord stimulation are:
- Chronic Sciatica or Arm Pain
- Complex Regional Pain Syndrome (CRPS)
- Failed Back Surgery Syndrome (FBSS)
- Multiple Sclerosis
How does the technology work?
A spinal cord stimulator (SCS) is a small medical device, similar to a pacemaker, that uses electrical impulses to mask pain signals before reaching the brain. The small medical device (pulse generator) is placed under the skin and sends electrical signals to the “leads” to mask pain signals.
Are there any alternative treatments?
There are numerous minimally invasive therapies that patients with chronic pain try such as injections, nerve ablation, regenerative medicine, and intrathecal pain pump insertion. A comprehensive guide to minimally invasive therapy for chronic back pain can be found here.
How can I pick a good doctor?
If you’re interested in spinal cord stimulation (SCS) try to pick a doctor who performs spinal cord stimulation regularly, i.e., they have significant procedural skill and judgement. When you call the clinic, don’t hesitate to ask the front desk personnel how frequently the doctor performs spinal cord stimulation. Additionally, look for doctors who are fellowship-trained in pain management. These doctors are usually highly skilled in the diagnosis and treatment of pain because they have spent an additional year of training exclusively within the field of pain management.
What are some common myths and facts about SCS?
Three of the most common myths about spinal cord stimulation are as follows:
- Myth: The implanted spinal cord stimulator will be highly visible underneath my skin.
Fact: Spinal cord stimulator systems are not much bigger or thicker than a silver dollar. Unless you tell someone you have a spinal cord stimulator, they are unlikely to notice the implanted device. Some patients report they can feel their unit by pressing on their skin. This is not an abnormal finding and patients should not be concerned if they can feel the implant when pressing over the insertion site.
- Myth: Spinal cord stimulation is permanent, and if it doesn’t work, you are stuck with your implant.
Fact: Spinal cord stimulators are not difficult to remove. Through a small procedure, the implanted leads and battery pack can be disengaged and removed. In fact, before fully implanting a spinal cord stimulator, all patients are able to perform a trial run.
- Myth: Spinal cord stimulators only replace pain signals with equally uncomfortable “tingling” sensations.
Fact: Spinal cord stimulators can cause a sensation of tingling or prickling called “paresthesia.” However, newer spinal cord stimulation technology has allowed certain patients to experience pain relief without paresthesia.