If you're suffering from chronic or severe back or neck pain, spinal cord stimulation could be the right option for you. Spinal cord stimulation is beneficial in lowering pain and assisting people in returning to their daily routines. This procedure involves implanting a small pulse generator into the spine. The pulse generator produces electrical impulses to the spine that affect the transmission of regular pain signals. As a result, your back discomfort will be reduced by half or more, with few side effects.

Dr. George Rappard's Clinic has some of the best spine specialists in Los Angeles that provide spinal cord stimulation and other back and neck treatment services. Get in touch with us for an accurate medical evaluation and treatment solutions that are tailored to your specific needs.

An Overview of Spinal Cord Stimulation

Chronic pain occurs whenever the body's normal reaction to an injury persists for a longer period than expected. Chronic pain could make working, eating, exercising, or engaging in other everyday activities hard. It can debilitate the patient and result in additional chronic health conditions including depression, and weight gain, along with problems that arise from using too many painkillers.

The body and the brain are continually exchanging nerve signals. This serves to avoid injury by alerting a person when something wrong is happening. Sadly, when your nerves have been damaged, they can convey pain impulses to your brain even if no injury is present. To prevent the brain from receiving these impulses, spinal cord stimulation could be employed to block them.

Spinal cord stimulation treatment suppresses pain impulses before they can reach your brain. Electrical pulses are sent to the spine through a small apparatus that resembles a pacemaker. It aids in the effective management of severe pain and lowers your reliance on opioid drugs. This could be a treatment option for you if you experience chronic leg, arm, or back pain and haven't received relief from other treatments.

What is a Spinal Cord Stimulator and What Does It Do?

A spinal cord stimulator is an implanted gadget that reduces pain by transmitting low-voltage electric signals to the spine. Thin wires deliver currents from a small pulse generator to the spinal cord's nerve fibers. When activated, the spinal cord stimulator stimulates your nerves in the location where you're experiencing pain. Since the electric impulses modify and block the pain messages from getting to the brain, pain is lessened.

Some of these gadgets substitute pain sensations with paresthesia, a faint tingling sensation, using low-frequency currents. Other gadgets mask pain without the tingling sensation using burst or high-frequency pulses. Most devices have a setting for paresthesia-free function.

Stimulation does not treat the underlying cause of pain. It merely alters how the brain interprets it. The degree of pain relief consequently varies for every individual. The goal of the stimulator is to reduce pain by 50% to 70%. Nonetheless, even a slight decrease in pain might be helpful if it enables you to carry out your everyday tasks and use lesser medications. The stimulator doesn't also increase muscular strength.

Not everybody benefits from stimulation. The feeling could be uncomfortable for some people. Others might not get complete pain relief. This is why a trial session enables you to test the procedure out for approximately one week. If the procedure does not help you, the wires used in the trial can be retracted with no injury to your nerves or spine.

Types of Spinal Cord Stimulators

Spinal cord stimulator device systems take different forms. However, they all consist of these three components:

  • A battery-powered pulse generator for producing electrical pulses
  • A lead line with several electrodes that send electric signals to the spine
  • A portable remote control that may be used to change settings and switch the gadget on and off

Depending on how frequently they are used, non-rechargeable battery devices require surgical replacement every two to five years. Systems with rechargeable batteries may run for eight to ten years or more, but you have to charge them every day.

The pulse generator's settings can be programmed. Certain devices can detect changes in body posture, such as lying down or sitting and adjust the degree of stimulus to your movement. Other systems come with leads that could be individually tuned to treat certain pain regions. Others transmit a sub-perception signal that doesn't cause a tingly feeling. Your physician will recommend the best kind of device for your needs.

What is the Purpose of Spinal Cord Stimulation?

Spinal cord stimulation is most commonly employed when nonsurgical pain management methods have been unsuccessful in providing satisfactory pain relief. Spinal cord stimulators can be utilized to manage or treat a variety of chronic pain conditions, such as:

  • Back pain, particularly chronic back pain following surgery (also known as failed back surgery syndrome)
  • Spine-related injuries
  • Angina, a form of heart pain, is untreatable by other means
  • Perineum pain
  • Post-surgical pain
  • Arachnoiditis (a painful inflammatory condition that affects the arachnoid, the membrane that envelopes the spinal cord and brain)
  • Complex regional pain syndrome (CRPS)
  • Post-amputation pain
  • Nerve pain (for example, acute diabetic neuropathy as well as cancer-related neuropathy that arises from surgery, radiation, or chemotherapy)
  • Visceral pain
  • Peripheral vascular disease (PVD)

Spinal cord stimulation could enhance general well-being, promote restful sleep, and lessen your dependency on painkillers. It is often used with other pain treatments such as exercise, medications, physiotherapy, and relaxation techniques.

Who is the Best Candidate For this Treatment?

An assessment of your pain history, physical state, and prescription routine will establish whether your pain management goals are suited for spinal cord stimulation. Your history of any past procedures and therapies will be examined by a physiatrist, neurosurgeon, or pain expert. Since chronic pain can have emotional consequences, your psychologist will evaluate your situation to increase the likelihood of a successful result.

Patients chosen for spinal cord stimulation typically experience leg (sciatica), arm pain, or lower back pain that has lasted for more than three months and is incapacitating. They've also undergone one or even more spinal cord surgeries. You can qualify as a prospective candidate for spinal cord stimulation if:

  • Traditional treatments were unsuccessful
  • Having more surgeries wouldn't be beneficial to you
  • Your pain is brought on by a fixable problem that needs to be addressed
  • You don't want any more surgeries due to the complications or the long recuperation periods
  • You don't use drugs or have undiagnosed depression, which should be addressed before getting a spinal cord stimulation
  • You don't have any health issues that would prevent you from getting implants
  • Your spinal cord stimulation trial was successful.

Who Will Carry Out The Procedure?

Spinal cord stimulators are implanted by neurosurgeons and physicians with expertise in pain treatment, such as anesthesiologists or physiatrists.

Spinal Cord Stimulator Surgery

There are two steps involved in evaluating whether a spinal cord stimulator would be an appropriate choice for you. First, you should go through a trial period to check if the device reduces your pain level.

Spinal Cord Stimulator Trial

A trial period is the first step. Your physician will insert a temporary device in your body for you to try out. Your surgeon would carefully implant the devices in the epidural area of the spine under the guidance of a special kind of X-ray known as fluoroscopy. These electrodes would be positioned at various points along the spinal column depending on where your pain is located. During the surgery, your surgeon would ask for your feedback to determine the best place to position the devices.

This trial operation normally involves a single incision made on the lower back to insert the electrodes. The battery or generator would be located outside of the body, usually on a belt that you will wear around the waist.

You will assess the device's effectiveness at relieving your pain for roughly a week. If you notice a 50% or higher reduction in pain, the trial will be considered successful. If the procedure is unsuccessful, the wires could be easily removed in a clinic without causing any damage to your nerves or spinal cord. If the trial is successful, surgery is planned to permanently insert the device.

Implanting a Spinal Cord Stimulator

In a permanent implantation operation, sterile electrodes are used in place of the trial electrodes and the generator is put underneath the skin. These electrodes, as opposed to the trial electrodes, will be secured by sutures to reduce mobility. The implantation technique is normally carried out as an outpatient operation, lasting between one and two hours.

After administering local anesthesia, the surgeon will make a small incision (usually around the buttocks or lower abdomen) to hold the battery/generator as well as another cut (along the spine) to implant the permanent devices. The small incisions made are about the size of a driver's license card. Fluoroscopy, as in a trial operation, is used to establish where the permanent electrodes should be placed.

Once the generator and electrodes are connected and operational, your surgeon would stitch up the incisions. The surgeon would administer anesthesia to make you comfortable and seek feedback from you while the electrodes are being placed.

The Recovery Process

Most patients get discharged on the same day of their procedure when the anesthesia wears off. Your incisions might be painful for a few days following surgery. Avoid stretching, twisting, or reaching since these actions could cause the incisions to rip. The incision areas will be covered with dressings, which would be taken off after 3 days. Incisions usually recover between two and four weeks after the operation.

Your physician will review the recovery plan with you, but for the first two weeks after the operation, you should limit your activity. You could start exercising regularly after your doctor gives the go-ahead and resume driving and working (with the spinal cord stimulator switched off). This usually happens one to two weeks after the operation.

What to Expect After Your Spinal Cord Stimulation Procedure

Spinal cord stimulation results are often dependent on successful trial stimulation, careful patient selection, patient education, and proper surgical techniques. Stimulation doesn't treat the underlying cause of the pain. Instead, it aids patients in managing their pain. Spinal cord stimulation is effective if the pain is minimized by at least 50%.

Spinal cord stimulation treatment is reversible. If a person decides to cease therapy at any moment, the generator and electrode wires can be removed.

Risks Associated with Spinal Cord Stimulation

Surgical procedures can be risky. Some of the general complications include blood clots, infection, bleeding, and anesthesia-related reactions. Specific complications associated with spinal cord stimulation include:

  • Epidural bleeding, infection, hematoma, compression of the spinal cord, and paralysis
  • A seroma (pocket of fluid) near or around the implant area. Seromas often disappear on their own, but sometimes may need to be drained.
  • Unwanted changes in stimulation (perhaps due to changes in electrode location, cellular changes in the tissue around the electrodes, loose electrical connections, or lead failure)
  • Leakage of the cerebrospinal fluid
  • Persistent pain felt at the stimulator site or electrode
  • Battery leakage and/or failure
  • Paralysis, clumsiness, weakness, pain, or numbness below the implantation level
  • Allergic reaction to the implants
  • Local skin erosion and/or generator migration
  • Lead migration, which could alter stimulation and reduce the ability to relieve pain

Conditions that could necessitate subsequent surgery include lead movement, breakage of the extension wire or lead, or (in rare circumstances) mechanical malfunction of the stimulator. The main reasons for removing the device include infections and failure of the device to ease the pain. Scar tissue can form around the electrodes, making stimulation less effective.

Find a Los Angeles Spinal Cord Stimulation Expert Near Me

Do you have chronic pain that won't go away despite trying traditional therapies like painkillers and physiotherapy? It's perhaps time to think about having spinal cord stimulation. At Dr. George Rappard's Practice, we address all of your concerns and issues and do our best to keep you informed and at ease at all times.

Our practitioners are specialists in this treatment procedure and will evaluate your case to see whether spinal cord stimulation is the best course of action for you. We will make sure that you receive a complete, and stress-free recovery. Call us today at 424-777-7463 to speak with a spinal cord stimulation expert in Los Angeles who can guide you through this procedure.