Neuromodulation
Spinal Cord Stimulation
A trial-first pathway for refractory neuropathic pain
Spinal cord stimulation uses programmable electrical signals to change how selected chronic neuropathic pain signals are processed—and includes a temporary trial before permanent implantation.
This guide is educational and cannot determine candidacy. Every treatment has limitations and risks, and outcomes are not guaranteed. A clinician must review your diagnosis, health history, imaging, medicines, and goals.
What it targets
A procedure built for a particular pain mechanism.
Thin leads placed in the epidural space deliver programmed electrical patterns that modify pain signaling before it reaches the brain. Modern platforms may use conventional, burst, high-frequency, or other waveforms. Some produce a tingling sensation; others are designed to work without it.
Who may be evaluated
Candidacy begins with diagnostic fit.
SCS may be discussed when chronic neuropathic pain remains disabling after appropriate medical, rehabilitative, and interventional care and no correctable structural problem better explains the symptoms.
Clinical considerations
- Persistent neuropathic pain after spine surgery in selected patients
- Complex regional pain syndrome or other qualifying refractory neuropathic pain
- Painful diabetic neuropathy in appropriately selected patients
- Failure of reasonable conservative and less-invasive treatments
- Ability to complete a trial, operate the system, and attend long-term programming visits
Evaluation may include
- Comprehensive pain, neurologic, imaging, and prior-treatment review
- Assessment for surgically correctable compression or instability
- Psychological evaluation focused on coping, expectations, and implant readiness
- A temporary stimulation trial with predefined pain and functional goals
How it is performed
The procedure, step by step.
Temporary trial
One or more leads are placed through the skin into the epidural space and connected to an external generator for a short evaluation period.
Goal review
The patient and physician compare pain, sleep, activity, medication use, and function with the goals established before the trial.
Permanent implant when justified
If the trial is meaningfully successful, leads and a pulse generator are implanted under the skin and programmed for ongoing therapy.
After the procedure
Recovery, follow-up, and important risks.
Recovery & follow-up
- Trial and permanent implantation have different aftercare plans.
- After permanent implantation, bending, twisting, and lifting are restricted while the leads scar into place.
- Programming visits are part of treatment and may continue as pain patterns or goals change.
- Rechargeable and non-rechargeable systems have different maintenance and battery-replacement needs.
Risks & limitations
- Infection, bleeding, epidural hematoma, cerebrospinal fluid leak, and rare neurologic injury
- Lead migration or fracture, hardware malfunction, and battery failure
- Loss of benefit or changing pain coverage over time
- Potential future surgery for revision, removal, or generator replacement
Alternatives to discuss
Evidence & technology
What is established—and what is still being studied.
Evidence in context
SCS is established for several indications and many patients report meaningful medium-term improvement. The long-term evidence varies by condition and device, and loss of effect or revision is possible; the reversible trial is therefore central to decision-making.
Brands are examples, not endorsements
Abbott, Boston Scientific, Medtronic, Nevro, and other manufacturers offer different waveforms, battery formats, and MRI conditions. Brand selection is individualized; no manufacturer is presented as universally superior.
Common questions
A useful conversation starts here.
Related patient guides
Compare nearby clinical pathways.
Bring the questions with you
Find out whether the diagnosis fits the treatment.
Request an evaluation at one of our three South Florida offices.