A spinal cord stimulator is a small implanted device that sends mild electrical pulses to the spinal cord, changing the pain signals travelling to your brain before you experience them. It does not fix a disc, a nerve or a joint. It changes how much of the pain gets through — which, for people whose nerve pain has outlasted everything more conservative, is often the difference between managing and not.
Two parts sit under the skin: thin leads placed in the epidural space near the nerves generating the pain, and a small generator, usually in the upper buttock or flank. You control it from a handheld remote or a phone app, turning it up, down or off.
It is deliberately a late option. Medication, Physical Therapy, injections and radiofrequency ablation come first, and a stimulator is what we discuss when those have been genuinely tried and the pain is still running your life.
Stimulation works best on nerve pain — burning, electric, shooting pain — rather than on mechanical, movement-triggered pain.
Nobody gets an implant on the strength of a conversation. The trial is a temporary version of the same thing: thin leads are placed through a needle in the epidural space, connected to an external generator you wear on a belt, and you go home and live normally with it for roughly a week. Nothing permanent is placed, and the leads are simply withdrawn at the end.
The point is to answer the question with your own experience rather than a prediction. What we and your insurer are looking for is at least a 50% reduction in the pain you are targeting — or the same reduction in the medication you need for it — together with a real improvement in what you can do. Insurers, Medicare included, also require a psychological evaluation before a permanent implant, which is standard rather than a judgement about you: chronic pain and mood are entangled, and the assessment is part of predicting who does well with the device.
If the trial does not clear that bar, we do not implant. That is the trial working, not failing.
If the trial worked, the permanent system is placed as an outpatient procedure. The leads go in the same position that worked during the trial and the generator sits under the skin. You go home the same day, with lifting and bending restrictions for a few weeks while everything settles into place.
Programming is not one-and-done. Most people come back to have the settings adjusted as they find what works for different activities and times of day, and modern systems hold several programs you can switch between yourself. Batteries are either rechargeable or replaced after several years, depending on the system.
The device is removable. That is worth saying plainly, because it is the part people are most anxious about: this is not a fusion or a nerve that has been cut. If it stops helping, or you simply do not want it, the hardware comes out.
A stimulator is a real procedure with real risks, and anyone who tells you otherwise is selling something. The common problems are mechanical rather than dangerous: a lead can shift out of position and need repositioning, the coverage can change over time, or the site can be sore for longer than expected. Infection is uncommon but is the reason the implant is treated as a sterile procedure and why you will be told to call about redness or fever rather than wait.
It is also not a cure. The realistic goal is a large reduction in pain and a return to things you had stopped doing — not zero. We would rather set that expectation now than have you find out afterwards.
Yes — both. The same physicians who evaluate you run the trial and place the permanent system, so nothing is handed off mid-course.
Roughly a week. You wear an external generator, keep to your normal routine as far as possible, and we compare notes at the end.
Because insurers, Medicare among them, require it before a permanent implant, and because it genuinely helps predict who does well. It is a standard step in the pathway, not a comment on you.
Yes, when the criteria are met — a documented trial showing at least 50% improvement, the psychological evaluation, and evidence that more conservative treatment has already been tried. See Medicare in Colorado or Medicare in Arizona.
Many current systems are MRI-conditional, meaning scans are possible under specific conditions. Which conditions depends on the system you have, so tell any imaging department that you have a stimulator and bring your device card.
Depends on the system and the programme. Some produce a light tingling over the painful area; others work at frequencies you do not feel at all. You control the intensity, and you can turn it off.
No. You can request an evaluation directly in Colorado or Arizona. Most people who end up with a stimulator get there through a course of Pain Management rather than asking for one on day one.
Spinal cord stimulation is offered by our Pain Management physicians in Colorado and Arizona — see the full clinic map, Colorado or Arizona.
