Tips to Live By

Spinal Cord Stimulation On Tap to Treat More Conditions

April 16, 2024 - Patti Muck

Maybe you've heard of spinal cord stimulation for pain relief. The term may sound slightly freakish, conjuring up images of Frankenstein and mad scientists, but the technology has been around for decades.

In recent years, spinal cord stimulation (SCS) has become a promising option when other pain therapy has failed. Several new SCS devices, which deliver low-level electrical signals to block pain signals from reaching the brain, have been approved by the FDA, and more are on the horizon.

"Even though spinal cord stimulation has been around more than 40 years, the technological advances in stimulation over the last five to 10 years are giving people with pain better options and better pain control — and for more pain conditions than ever before," says Dr. Sagar Chokshi, a pain management specialist at Houston Methodist. "SCS also provides the benefit of not requiring major surgery or constant pain medications."

The variety of ailments SCS shows promise for treating ranges from failed back surgeries to, most recently, pain caused by diabetes and neuropathy.

Spinal cord stimulation doesn't cure or structurally alter the spine but works by sending mild electrical impulses to the spine that interrupt pain signals to the brain. A battery pack is implanted in the lower back and connected to thin wires fitted around the fluid sac that contains the spinal cord. The timing and intensity of the impulses are programmed after implantation, and a remote control gives patients the ability to adjust the pain-blocking impulses with guidance.

Additional treatment options for pain relief are badly needed. More than 20 percent of the U.S. population — 51.6 million adults — live with chronic pain, according to the National Institutes of Health. About one third of those adults are substantially restricted in their ability to work or participate in daily activities.

One patient's story

Linda Trahan, 77, a retired Beaumont nurse, turned to SCS as a last resort after pain led to depression and desperation. After four lower back surgeries, she was in constant pain — and had exhausted the temporary relief provided by periodic steroid injections. What's more, almost every pain medication on the market made her sick.

A pain management specialist convinced Trahan SCS was worth a try.

Eight months after the permanent implant, Trahan is walking a mile every day, looking into tai chi classes to help improve her balance and considering volunteer work.

"This technology has changed my life immensely for the better," says Trahan.

Chronic pain can rule and ruin a life

Pain is an aggressive companion. It affects every aspect of life — emotional and mental health, social ties, family relationships, mood, appetite, physical movement, sleep, career and finances. In worst-case scenarios, pain can lead to depression, even suicide.

Lower back trouble, like that which afflicted Trahan, is the No. 1 cause of pain and disability for the U.S.'s growing elderly population. The World Health Organization estimates more than 620 million people around the globe suffer from it. While lower back pain can affect anyone of any age, it zeroes in on those 65 and older with conditions like spinal stenosis and osteoarthritis.

For Trahan, it was 46 years as a licensed vocational nurse and the stretching, bending, reaching, lifting and other duties that came with it. The back surgeries gave her "a jacked-up back" that had seen it all.

Are you a candidate for spinal cord stimulation?

While Trahan is a classic case of a patient suited to SCS, not everyone is a candidate, says Dr. Chokshi.

"Someone like Linda had back surgery, knows what's involved and was not interested in another," says Dr. Chokshi. "She didn't have many options until I discussed SCS with her. She was physically unable to tolerate any opioid-type pain medication, and, besides, those drugs can be dangerous and addictive. The spinal injections she received lasted a few months but were not enough help. She was in overall good health and able to face the minimally invasive surgery to implant the battery pack and leads if the trial was successful."

"Patient selection is critical in deciding who is right for this treatment," he explains. For instance, patients with chronic systemic infections are not good candidates.

Physicians hope for 50-60 percent pain reduction with the therapy, albeit some patients have even more benefit.

SCS is currently approved by the FDA for:

  • Failed back surgery
  • Neuropathic pain (caused by neuropathy)
  • Complex regional pain syndrome
  • Post herpetic neuralgia
  • Diabetic neuropathy/diabetes
  • Non-surgical back pain


One huge benefit of SCS is patients' ability to give it a trial run. Dr. Chokshi does the procedure in his office, inserting the leads with a needle in a procedure that takes a little more than an hour. The electrical impulses are controlled with an external transmitter, and the temporary implant stays in about a week to help patients decide if this is a route they want to take.

Collaboration is the key — neurosurgery and pain management

Thanks to the growth of the U.S. elderly population, Dr. Chokshi's Houston Methodist pain management office is busy with older people seeking pain relief and renewed quality of life. It has led to a close partnership with neurosurgeon Dr. Amir Faraji, who implants the spinal cord stimulator in a straightforward outpatient procedure that involves a small bone opening less than the size of a fingernail. The surgery takes about an hour to perform.

Pain management physicians like Dr. Chokshi are a natural avenue to screen patients who will most benefit from SCS, Dr. Faraji says.

"New indications for spinal stimulation are expanding rapidly and there are so many clinical trials underway, including expanding the use of spinal stimulation in diabetic neuropathy," he explains. "Diabetes is a huge patient burden and to help modulate its pain symptoms can be extremely helpful."

As part of the relatively new Rice/Houston Methodist Center for Neural Systems Restoration, Dr. Faraji notes that there are additional SCS clinical trials for motor restoration in patients with spinal cord injury and stroke damage.

Communicating with a spinal cord stimulator

Trahan says SCS demands good patient education and is a personal decision for those considering the therapy. Her home is two hours from Houston Methodist Hospital, but the electrical impulse settings can be checked and reprogrammed remotely.

She checks her battery power daily with a remote control and monitors how her body feels after a full day of living. Occasionally, she returns to the hospital for an in-person SCS 'tweaking' session to help with any breakthrough pain.

Compared to her life before SCS, Trahan says, the pain is dramatically reduced. In fact, it's nearly gone.

But there are some things she still can't do. She had to tell her young great-grandson that she cannot use her remote control to perform a backflip.

Stay up-to-date
By signing up, you will receive our newsletter with articles, videos, health tips and more.
Please Enter Email
Please Enter Valid Email
Categories: Tips to Live By