Spinal cord stimulation: a revolution for control of back pain
Written by:Back pain is very common, affecting 40% of the population in the UK. This can affect the quality of life, activities of daily living and impact on your social and mental behaviour.
Spinal cord stimulation (SCS) is a NICE recommended procedure that has helped patients with back and leg pain. We asked pain medicine and neuromodulation specialist Dr Kavita Poply all about SCS (the “pacemaker for back pain”), including how it works to how much it costs.
What is spinal cord stimulation?
Spinal cord stimulation (SCS) is a form of the neuromodulation technique that involves managing back and leg pain effectively. This is with the use of an implantable pulse generator (IPG), which is a form of spinal “pacemaker” that helps control the pain.
Which patients would benefit from spinal cord stimulation?
Patients who have low back pain with radiation to the legs are particularly good candidates of the therapy. Clinical trials have shown a good result in patients who have undergone spinal surgery but still in pain (about 25 to 40% of the population).
Patients who have back pain and are not suitable for spinal surgery (such as spinal fusion) also demonstrate significant benefit. This therapy shows good to excellent long-term relief in 50 to 80% of patients suffering from chronic pain.
How is it done?
It is a simple day-case procedure, which means that the patient goes home on the same day. The procedure involves placing electrodes (therapy leads) in the epidural space (outside the spinal column) and IPG (battery, “the pacemaker”) in the buttock area. It takes approximately 60-90 minutes and is usually done under anaesthesia.
Is it available on the NHS and do private medical insurers pay for it?
The procedure is now the standard of care for patients with intractable neuropathic pain (shooting pain, numbness and pins and needles) of back origin, and is recommended by NICE. Currently, 1500 implants are performed annually in the UK. This is performed in certain specialised centres in the NHS and most private medical insurers cover it.
Will I feel the implant? Can anyone see it?
The implant is small and has a contoured oval shape. This can be positioned in the most comfortable and convenient location in your body. Some people say that they can feel it if they press on their skin. In most cases, it isn’t visible.
Will this procedure allow me to stop taking pain medications?
For some people, SCS works well enough that they don’t need pain medication. For others, it can mean taking less pain medication.
Is spinal cord stimulation safe?
SCS has been proven safe and effective and has been in use for decades. More than 400,000 people worldwide have been successfully treated with SCS therapy. Complications of surgery are compatible with any other minor procedure. In an unlikely scenario that it may not work, the procedure is reversible so the device can be taken out safely.
Can I use my SCS system 24-hours a day?
It’s up to the individual. The system is designed for 24-hour-a-day use, should you wish to do so. However, there are times when you should avoid turning on stimulation, for example, when driving.
What happens when I go through airport security?
Airports differ in their screening processes. When you go through the security, let them know that you have an implanted neurostimulator and they will direct you to the appropriate place. You will have an ID card to show that you have an implanted device, and you may be escorted around the security machine.
How do I get a referral at the Holly?
You should contact your GP, physiotherapist, osteopath, chiro practitioner, spinal surgeon or pain physician to get a referral. We also accept self-referrals in certain cases. We will arrange an up to date scan and you will have an education session about the use of the device before we offer it.
I offer SCS at Holly for self-payers. The package price is around £24,500. Financing schemes are available.
Dr Poply is a pain medicine and neuromodulation specialist in London. You can book an appointment with her via her Top Doctor’s profile here. Can’t see Dr Poply in person? She is available for a video call using our e-Consultation tool – also found on her profile!
