How Spinal Cord Stimulation Compares with Other Pain Management Options

Also known as dorsal column stimulation, spinal cord stimulation provides an alternative means of pain management that could offer results when other procedures, particularly surgery, prove ineffective. In addition, the procedure is frequently sought for peripheral neuropathy, reflex sympathetic dystrophy, arachnoiditis, and causalgia.

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The entire procedure is minimally invasive, with an implant placed in the spine or just under the skin close to the affected region. The implant releases a current, controlled through a handheld device, which creates a pleasant sensation while blocking the pain signals of the affected nerves. 

Spinal cord stimulation offers a drug-free approach to pain management, relying instead on electricity to manage pain. This avoids many of the risks associated with using medications for chronic pain management (especially in the case of particularly risky drugs), particularly the tolerance that builds up over time when drugs are taken orally. Because it is comparatively minimally invasive, the treatment also exposes the patient to less risks than another attempt at surgery. 

In addition, unlike most surgical implants such as targeted drug delivery, spinal cord stimulators are first installed as a trial before being replaced by a more permanent system. Lasting about a week, the trial takes 20 minutes to install and is used to determine the efficacy of the treatment. It is also easily removable when proven ineffective or deemed no longer necessary.

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As with many treatments, there are contraindications to spinal cord stimulation such as systematic infection, pregnancy and lactation, sensitivity to transcutaneous electrostimulation, and pacemaker use. In addition, the procedure is limited in its effectiveness, with only between 50 and 60 percent of patients reporting efficacy of pain reduction. Moreover, being only a means of systematic relief, it does not address the source of the pain itself; it is therefore often given only after surgery or physical therapy had been tried. 

Joseph Yazdi, MD, is a neurosurgeon specializing in chronic pain management through spinal cord stimulation and other minimally invasive surgical techniques. For more on this and other procedures involving the vertebral column and spinal cord, visit this blog.