What is Neural Stimulation?

Neural stimulation, also known as Spinal cord stimulation (SCS), or dorsal column stimulation, is an advanced treatment for certain types of chronic pain. SCS is actually one of a number of medical therapies in a broad category of medical devices called neurostimulators. Over the last 20 years, thousands of people with severe chronic pain have received pain relief with spinal cord stimulation.
SCS uses a small implanted device - called a pulse generator or receiver - to generate low-level electrical impulses to stimulate targeted nerves along the spinal cord. The stimulation interferes with the transmission of pain signals to the brain. When successful, painful sensations are replaced with what some patients describe as a more pleasing sensation, called paresthesia.

COMPONENTS OF AN SCS SYSTEM

To understand how spinal cord stimulation works, it is helpful to understand the different components of the two different types of SCS systems - IPG and RF.

The first type of system is an Implantable Pulse Generator (IPG). An IPG's power source consists of a battery and related electronics that are housed in a single metal container. The IPG is completely implanted under the skin in a practical location agreed upon by you and your physician (e.g., the abdomen, just below the beltline and above the buttocks, etc.). Leads are placed over the spinal cord and connected to the IPG. It is important to note that from time to time a surgical procedure is performed to replace the IPG with a new one because the battery has become depleted.

The second type of system is a Radio Frequency (RF) spinal cord stimulator. RF spinal cord stimulators are similar to IPGs except the battery that supplies the power is a rechargeable, cell-phone type battery that is located outside the body, contained in a small controller called a transmitter. The transmitter delivers radio waves through the skin to an implanted receiver. The receiver in turn sends the mild electrical energy to the leads.

HOW SCS WORKS

The implanted components of the SCS system are placed during a surgical procedure, which, depending on the type of leads placed, can be brief and minimally invasive. The leads are positioned in the space above the spinal cord (called the epidural space). The IPG or receiver is placed just under the skin in a practical location that is acceptable to you and your physician. The leads are then connected to the IPG or receiver. When the power source is turned on, the electrodes on the leads will stimulate specific nerve fibers that affect the areas of your pain. The stimulation of these targeted nerves is intended to change how the brain perceives the pain signals. Instead of feeling pain, a different sensation is felt in areas that normally hurt. Most patients say this new sensation feels like tingling. The medical term for this sensation is paresthesia.

WHO SCS CAN HELP

Spinal cord stimulation is approved to treat chronic pain of the trunk and/or limbs. It is most effective in relieving persistent or severe neuropathic pain. This type of pain can be caused by injury to nerves and is often felt as an intense burning or stabbing pain. Neuropathic pain can be very stubborn and disabling since it often does not respond effectively to many standard therapies.
Spinal cord stimulation is not a treatment option for everyone. Remember, SCS is considered an advanced pain treatment, which means that SCS is generally not considered an option until more conservative, and/or less expensive pain therapies have been tried and failed to adequately control your pain. These therapies include bed rest, over-the-counter pain relievers, NSAIDs, nerve blocks, opioids and perhaps, corrective surgery.

A number of other factors also affect whether you are a good candidate for SCS. These include your diagnosis and medical history, as well as the severity, location and type of pain. Successful SCS therapy also requires that you be a willing partner in the therapy. An open and honest dialogue with your physician and your family will help you to determine if SCS is an option for you.

Click here to download a Spinal Cord Stimulation Information Sheet

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