What it is
Spinal cord stimulation (SCS) is a reversible, FDA-approved therapy that uses a small implanted device to deliver gentle electrical signals to the spinal cord. Those signals interrupt or modify the pain messages traveling to your brain — so your brain perceives less pain, or replaces it with a more tolerable sensation.
Modern stimulators are programmable, often paresthesia-free (no buzzing or tingling), and can be tailored to your specific pain pattern. The technology has advanced dramatically over the last decade.
You try it before you commit. Unlike most surgeries, SCS includes a 5 to 7 day trial with a temporary device. If the trial gives meaningful relief, you can move forward with the permanent implant. If it doesn't, you stop — no implant, no commitment.
Who it helps
You may be a candidate if you have:
- Chronic radicular leg or arm pain that hasn't responded to injections, medications, or PT
- Failed back surgery syndrome (persistent pain after spine surgery)
- Complex regional pain syndrome (CRPS)
- Painful peripheral neuropathy, including diabetic neuropathy
- Chronic pain that's significantly limiting your daily life
- A clear pain pattern and no contraindications to implant
What the process looks like
Consultation & Candidacy
We review your history, exam, imaging, and prior treatments to determine if SCS is appropriate. Insurance pre-authorization typically happens at this stage.
Psychological Evaluation
Required by most insurance plans before SCS — a brief screening to identify any factors that might affect outcomes. It is not a barrier; it is a standard part of the workflow.
The Trial (Week 1)
Outpatient procedure where temporary leads are placed under image guidance. You wear an external generator for 5 to 7 days, going about your normal life, while we tune the settings to your pain pattern.
The Decision Point
If the trial gave you 50% or greater pain relief and meaningful functional improvement, we move forward with the permanent implant. If not, we remove the trial leads and explore other options.
Permanent Implant
Outpatient procedure to place a small generator under the skin (typically in the upper buttock or flank) connected to permanent leads. Most patients go home the same day and resume light activities within a few days.
Programming & Long-Term Follow-Up
Settings are fine-tuned over the following weeks. We follow you long-term to optimize the program as your pain patterns evolve.
Risks and what to watch for
SCS has a strong safety profile, but like any implanted device it carries some risks: infection at the lead or generator site, lead migration, hardware issues, or — rarely — nerve injury. We screen carefully for candidates and use sterile technique under image guidance to minimize complications.
Call us right away if you develop fever, redness or drainage at an incision, sudden loss of stimulation, or new neurologic symptoms after a procedure.
What life with SCS looks like
- You control your stimulator with a small remote — adjusting intensity, switching programs, or turning it off as needed
- Most modern systems have rechargeable or long-life batteries (generally 7 to 25 years depending on system)
- You can travel, exercise, and return to most activities — your team will tell you about specific restrictions
- MRI compatibility depends on the specific device — most newer systems are conditionally compatible
Frequently asked questions
What if the trial doesn't work?
Then we don't implant. The whole point of the trial is to find that out before any permanent commitment. The temporary leads are simply removed and we redirect to other options.
Will I feel the stimulation?
It depends on the program. Some modes produce a gentle tingling that replaces the pain (paresthesia-based); newer modes are paresthesia-free, meaning you feel relief without feeling the stimulation itself.
Is it covered by insurance?
Yes, in most cases — including Medicare — when criteria are met. We handle the pre-authorization process and verify your specific coverage before the trial.
Can I have an MRI later?
Usually yes, with conditions. Most current SCS systems are MRI-conditional, meaning MRI can be done with specific protocols. We'll give you a card describing your device for any future imaging.
Can the system be removed if needed?
Yes — SCS is fully reversible. The leads and generator can be removed if needed, though most patients who do well with their systems keep them long-term.