What is spinal cord stimulation?
Spinal cord stimulation is a form of neuromodulation that uses a small electrical device to influence the transmission of pain signals along the spinal cord. A system consists of thin leads positioned in the epidural space near the spinal cord, a small pulse generator that produces the stimulation, and a handheld controller that allows you to adjust settings.
Rather than removing tissue or correcting the physical source of pain, SCS works by modulating the nervous system’s processing of pain signals.
The goal is to reduce the intensity of chronic pain and, in many patients, improve their ability to function and participate in everyday activities.
Cervical vs. lumbar stimulation
The location of the stimulation leads depends on where the pain is originating. Cervical SCS is generally used when chronic pain primarily affects the neck, shoulders, arms, hands, or upper extremities — including persistent pain after cervical spine surgery and certain CRPS presentations.
Lumbar SCS is commonly used for chronic pain involving the lower back, buttocks, hips, legs, or feet — including sciatica, lumbar radiculopathy, persistent leg pain after spine surgery, Failed Back Surgery Syndrome, and peripheral neuropathy.
The precise placement of the leads is determined based on the location and characteristics of your pain.
Who may be a candidate?
SCS is not appropriate for every patient with chronic pain. Careful evaluation and patient selection are important to achieving a successful outcome. Spinal cord stimulation may be considered when a patient:
Depending on the condition, SCS may be considered for Failed Back Surgery Syndrome, CRPS, peripheral neuropathy, chronic radiculopathy, and other persistent neuropathic pain conditions.
SCS for Failed Back Surgery Syndrome
One of the most established applications of spinal cord stimulation is the treatment of persistent pain following spine surgery. Patients with Failed Back Surgery Syndrome may continue to experience significant back or leg pain despite having undergone one or more surgical procedures.
For appropriately selected patients — particularly those with persistent neuropathic or radiating leg pain — SCS can provide an advanced treatment option when additional surgery is unlikely to provide meaningful benefit.
If you have already undergone spine surgery and continue to experience significant pain, you may have options beyond another operation or simply living with the pain.
SCS for CRPS & nerve pain
SCS can also be used to treat certain forms of chronic neuropathic pain, including appropriately selected patients with Complex Regional Pain Syndrome (CRPS) and peripheral neuropathy. These conditions can produce burning, electrical, shooting, or severe pain that may be difficult to control with conventional treatments.
Because SCS works directly on pain signaling within the nervous system, it can be an important option for patients whose pain has not responded adequately to medications, injections, or other therapies.
The spinal cord stimulation trial
One of the major advantages of SCS is that patients can typically experience the potential benefits before committing to permanent implantation.
During the trial, temporary leads are placed near the spinal cord and connected to an external pulse generator. You then go home with the temporary system and use it for a predetermined period, allowing you and Dr. Shamloo to evaluate whether stimulation provides meaningful improvement in pain and function.
If the trial provides significant benefit, you may proceed with permanent implantation. If it does not provide adequate relief, the temporary leads can be removed without leaving a permanent device behind.
How does stimulation work?
Traditional spinal cord stimulation delivers carefully controlled electrical stimulation through leads positioned near the spinal cord. Depending on the device and programming approach, stimulation may produce a tingling sensation known as paresthesia, while newer stimulation technologies can provide pain relief with little or no sensation.
The electrical signals interact with the nervous system and can alter how pain signals are processed. Modern systems offer multiple programming options, allowing stimulation to be customized to your pain pattern.
The goal is not simply to mask pain — it is to help change how the nervous system processes chronic pain.
Potential benefits
For appropriately selected patients, spinal cord stimulation may:
Results vary between patients, and SCS does not eliminate the underlying condition causing chronic pain. The goal is to reduce pain and improve quality of life and function.
A personalized approach to neuromodulation
There is no single spinal cord stimulation system or programming strategy that is right for every patient. Dr. Shamloo evaluates the location, type, severity, and cause of your pain, along with your previous treatments and overall goals, before determining whether SCS is appropriate.
When SCS is recommended, the stimulation strategy and lead placement are tailored to your individual pain pattern.
The goal is to use neuromodulation as part of a broader treatment strategy designed to help patients reduce pain, improve function, and regain more control over their daily lives.