Overview
SCS is most often considered when pain is driven by nerve sensitisation rather than a single structure that can be treated with injections or surgery. It may be used for persistent back and leg pain after spinal surgery neuropathic leg pain and other long standing pain conditions where quality of life is significantly affected.
A key feature of the SCS pathway is the trial stage. Before any permanent implant decision a temporary system is used to assess whether stimulation provides meaningful benefit for your specific pain pattern and functional goals.
Who This Treatment Helps
SCS may be considered for people with:
• Persistent neuropathic back and leg pain including sciatica like symptoms in selected cases
• Pain after spinal surgery often referred to as failed back surgery syndrome
• Chronic nerve related pain where imaging and assessment do not indicate a better surgical target
• Complex regional pain syndrome in selected patients
• Pain that significantly limits walking sleep work or daily activity despite other treatments
• A pain pattern suitable for stimulation based on clinical assessment
A consultation is required to confirm suitability and discuss expectations.
What Is Spinal Cord Stimulation
SCS involves placing thin leads near the spinal cord in the epidural space. These leads connect to a small implantable pulse generator usually placed under the skin. The device delivers electrical stimulation designed to modify pain signalling.
Modern systems vary and may use different stimulation waveforms. Your consultant will explain which approach is being considered and why based on your pain pattern.
What to Expect During the Procedure Pathway
The pathway usually includes:
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Assessment and planning with review of diagnosis imaging and previous treatments
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Discussion of goals such as walking tolerance sleep improvement and ability to reduce medication
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Trial stimulation where temporary leads are placed and connected to an external stimulator for a short period
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Review of trial results based on pain reduction function improvement and overall benefit
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If successful permanent implant of the pulse generator and internal leads may be planned
The procedure is performed in a controlled clinical environment and is usually a day case or short stay depending on individual factors.
After the Procedure and Recovery
After the trial or implant you may be advised to:
• Limit bending twisting and heavy lifting for a short period to protect lead position
• Keep the dressing clean and follow wound care guidance
• Attend follow up for device programming to optimise results
• Continue rehabilitation to improve movement and function
Benefits are often enhanced by ongoing activity progression and careful pacing.
Benefits
Potential benefits may include:
• Reduction in chronic nerve related pain intensity
• Improved walking standing and daily function
• Better sleep and reduced flare ups in selected cases
• Reduced reliance on medication for some patients
• A reversible and adjustable treatment option with trial confirmation
Possible Risks and Side Effects
SCS is a specialist procedure and risks may include:
• Infection
• Bleeding
• Lead movement affecting stimulation coverage
• Local discomfort at implant sites
• Device related issues requiring reprogramming or revision
• Rare nerve irritation
Your consultant will explain personal risks and how they are minimised.
When to Consider Other Options
SCS may not be suitable if:
• Pain is not primarily neuropathic
• There is an untreated structural cause that should be addressed first
• There are medical factors that increase infection or procedural risk
• Goals and expectations do not align with likely outcomes
Other options may include targeted injections nerve blocks radiofrequency treatments rehabilitation or multidisciplinary pain management.
Safety Note
Please inform your consultant about blood thinners diabetes immune suppression allergies or any active infection. A full review is completed before any implant planning. The trial stage helps ensure the therapy is appropriate before committing to a permanent system.
Arrange a consultation to discuss whether spinal cord stimulation may be suitable for you.