Spinal cord stimulation is an increasingly popular technique used to treat persistent back pain. When other forms of back pain treatment like medication or surgery don’t work, many patients and doctors turn to spinal cord stimulation. Stimulators can help your back pain in several different ways, depending on the waveform being used. These waveforms include: tonic stimulation, high frequency stimulation and burst stimulation.
If you have persistent back pain and are looking for a better route to relief, spinal cord stimulation may be the right choice. Continue reading for an overview of how spinal cord stimulators can help your back pain.
About Spinal Cord Stimulation
The spinal cord is a part of the nervous system, which also consists of the brain as well as all of the body’s nerves. To understand how spinal cord stimulators can help your back pain, it’s helpful to get an idea of how the nervous system works.
Every nerve in the body communicates with the brain using electrical impulses. All types of sensory information, including pain, are transmitted to the brain this way. Several decades ago, scientists hypothesized that they could block pain, or at least reduce it, by interrupting the electrical currents that connect nerves to the brain. Their hypothesis proved correct, and in 1989 spinal cord stimulation was approved by the Food and Drug Administration (FDA) to treat back pain.
The technique has undergone significant improvements since then, but the basic concept has remained the same. Electrical currents are sent from a generator into the spinal cord where they interrupt pain signals before they can reach the brain, thus reducing your symptoms. There is a large body of evidence showing that spinal cord stimulation is a highly effective way to reduce back pain.
Comparing the Types of Stimulation
There are several types of spinal cord stimulation available, each coming with their advantages and disadvantages that you should carefully consider. Each patient can respond to one or more of these options, but there is no true way to predict ahead of time which will be best for any given patient.
Your doctor will recommend a trial of using one or more of these waveforms to assess which works best for you. Once that is determined, you can then undergo permanent implantation of whichever system you and your doctor decide on.
Tonic Spinal Cord Stimulation
Tonic spinal cord stimulation, or low-frequency spinal cord stimulation, is the form of this treatment that has been in use the longest.
This treatment involves low frequency electrical impulses (less than 1000 Hz) that the patient can feel as a tingling or vibration sensation. The stimulation electrodes placed into the spinal canal will stimulate spinal cord pathways, reducing the activity within separate pain pathways which carry pain signals up to the brain. The result is that patients feel a slight tingling sensation instead of back pain.
High Frequency Spinal Cord Stimulation
This newer form of stimulation involves high frequency electrical impulses (10,000 Hz) that the patient cannot feel as a tingling or vibration sensation. The stimulation electrodes placed into the spinal canal directly inhibit spinal cord pain pathways, limiting their ability to carry pain signals up to the brain.
High-frequency spinal cord stimulation generally tends to be more effective than the alternative simulation methods. Nonetheless, some patients respond better to tonic or Burst spinal cord stimulation. It depends on your personal experience with the treatment. An important part of how spinal cord stimulators can help your back pain is that they allow for trial periods. If one type of stimulation doesn’t provide effective results, you can try another.
Burst Stimulation
This newly-developed spinal cord stimulation wafeform involves intermittent bursts of high frequency electrical impulses. Patients generally report not feeling a tingling or vibration sensation. The stimulation electrodes placed into the spinal canal directly affect certain specialized spinal cord pain pathways, which not only limit the transmission of pain signals up to the brain, but also reduce the emotional effects of the pain on the individual. The result is that patients typically feel less or no pain. If pain still exists, patients often report it as much less severe than their typical experience.
What to Expect
By researching spinal cord stimulation and discussing it with your doctor, you can set appropriate expectations for your treatment. Here is a chronological overview of the treatment process so that you can gain a clear picture of how spinal cord stimulators can help your back pain.
The first step in spinal cord stimulation treatment is to place the stimulator. Both the trial and the permanent implantation involve outpatient procedures that may be performed either awake or asleep, depending on the type of stimulation that is being used.
Your surgeon will use an X-ray to visualize your spine and guide wires with small electrodes to the area where the pain is located. After that, they will activate the generator and you will work together to decide where exactly the electrodes should be placed. Your feedback during this stage may be important (depending on the waveform being used) — make sure that you tell your surgeon where you feel the stimulation so that they can place them accurately.
Once you and your surgeon have settled on the right place for the electrodes, the trial stimulator will be left in place. Immediately after the operation, the electrodes in your spine will be connected to an external generator, where they will stay for about a week. To determine whether the treatment is working properly, your surgeon will ask that you record your pain levels at different times of the day and in different situations.
If, after your trial period, you aren’t satisfied with the results, you can easily redo the procedure using a different waveform. Once you identify a waveform that is working well, you will return to your surgeon to have a permanent spinal cord system implanted. This procedure, like the electrode placement procedure, is relatively simple and done on an outpatient basis.
Final Thoughts
Spinal cord stimulation is an effective way to address back pain that hasn’t responded well to other forms of treatment, and it comes with a high level of flexibility.
As you gather information about how spinal cord stimulators can help your back pain, keep in mind that you can always discuss your condition with a qualified professional. Take the next step toward a more active and comfortable lifestyle and schedule a consultation today.
