Chronic pain is defined as pain that lasts for three months or more. Sometimes its severity can significantly disrupt a person’s life. In the United States, a survey by the National Institutes of Health found 25.3 million Americans suffer from daily pain, most commonly back pain and leg pain. Many of these individuals have tried everything for relief: medication, physical therapy, injections, and even surgery, but to no avail. In the majority of these cases, the pain is caused by an injury to the nervous system. Thanks to innovative neuromodulation therapies, which use electrical signals to directly stimulate the nervous system, chronic pain relief is possible. Spinal cord stimulation is a good example of how neuromodulation is used to relieve pain.

What is spinal cord stimulation?

Spinal cord stimulation involves superficially implanting a predictable, personalized stimulation device in the body (usually in the upper buttocks area). The device uses electrode contacts to alter the electrical signals coming from damaged nerves to the brain, interrupting the pain signals and restoring normal patterns. Some patients describe the results as miraculous, with their pain dropping from an 8 to a 3 (10 being the worst pain and 0 being no pain). In addition to personal experience, there is data to prove it.

How effective is it?

I was involved in a large study that looked at the clinical outcomes for patients implanted with a neuromodulation system for management of chronic pain. We collected data from 579 patients who underwent spinal cord stimulation across 40 study sites and found that more than 70 percent of patients reported significant pain relief (defined as a 50 percent reduction in their pain). The study’s results suggest 8 out of 10 patients are satisfied with spinal cord stimulation. Our research also shows that when chronic pain patients are provided with this stimulation, they also experience alterations in their emotional connectivity patterns, resulting in an improved mood.

How do you know if it works for you?

Spinal cord stimulation is a predictable and personalized therapy. We usually implant a test device for a period of 4-5 days to see if it helps. The test device implantation takes about half an hour at a doctor’s office. We thread a very thin wire with an electrode into a person’s back, underneath the vertebral column. The other side of the electrode comes out of the skin and attaches to the stimulator, which is taped to the person’s side, near the hip.

If the test device produces the desired results, we can move forward with implanting a permanent device. This is also an outpatient procedure involving local anesthetic. The device is adjusted to a person’s particular pain pattern, and patients go home with a remote control. They are in control of the stimulator and their pain.

People can choose to have a rechargeable device, which last 9-10 years, or a non-rechargeable device that lasts 3-5 years before it will need to be replaced. The stimulator can be turned off at any time, but then the pain will return. A spinal cord stimulator does not change a person’s anatomy in any way; it simply modulates the signals sent to the brain.


Learn more about spinal cord stimulation for pain relief.

Spinal Cord Stimulation

About the Author

Peter Pahapill, MD, PhD, FACS, is a neurosurgeon who practices at Froedtert Hospital. He specializes in the treatment of chronic pain and neuromodulation therapies, including deep brain and spinal cord stimulation. He also leads research in a number of areas of neuromodulation.