When alternative pain management isn’t enough to treat chronic back pain, there are still many different options. Some newer techniques are getting pretty hi-tech. Two procedures that treat chronic back pain – spinal cord stimulators and intrathecal pumps – involve inserting small devices near the affected area that can be controlled from outside of the body.

This type of system gives patients a little more control over managing and monitoring their pain.

Like with other surgeries, anyone considering an implantable pain management system has a pretty big decision to make. When patients turn to this type of option, it’s usually after alternative treatments have failed and back surgery is not an option. If successful, it reduces pain enough that people can experience significant improvement in their daily functioning.

One implant involves stimulation and the other medication. Both require a trial period, followed by a second procedure if the patient wants the device permanently.

What Is a Spinal Cord Stimulator?

Spinal cord stimulation (SCS) is used to treat people who suffer from neuropathic pain. This typically means it’s intended for someone whose pain is caused by damage to their nervous system. With SCS, mild electrical impulses are sent to the brain. In some patients, these pulses can prevent pain signals from being received by the brain and succeed in relieving their back pain.

This option might be for you if you’re tired of meds, want more control over your pain management, and are open to trying out a less conventional approach. As the patient, you get to program the electrical pulses with an external wireless programmer. You can adjust the power level and choose when the system is on or off.

Some potential benefits:

• Improved overall functioning
• Increased activity and mobility
• Less dependence on bracing

How Is the SCS Inserted?

Wire leads are inserted into an area near the spinal cord. Electrodes at the end of the leads produce electrical pulses that stimulate the nerves to block pain signals. The leads are then connected to a small, implantable pulse generator battery. A small incision is made and the battery is positioned beneath the skin, typically in the buttocks or abdomen.

During implantation, the patient provides feedback to the physician on where the pulses should be directed to relieve pain. This is followed by a trial period of about a week, so you can test the device and decide whether to move forward with a permanent one. Doing so would require another procedure for implanting the permanent device.

What Is an Intrathecal Pump?

With an intrathecal pump, a trial implant is inserted first so you can decide if a pump effectively controls your pain. It sends medicine into an area near your spinal cord that serves as a route for the administration of drugs. The medicine blocks pain in that area and can be effective at relieving chronic or long-lasting pain.

Like with the SCS, a trial period is necessary to see if this kind of system is successful at treating pain. If it is, the patient goes back for the permanent pump to be implanted. Some patients prefer this option because the medicine is delivered more locally and directly. As the pump targets the area where you feel pain, there’s less worry about having drugs throughout your entire system.

How Is an Intrathecal Pump Inserted?

During the procedure your skin is numbed and through a small incision, one end of a catheter is placed in a fluid-filled area near the spinal cord. The other end goes under your skin and around your body, typically to your abdomen, where it is connected to a temporary pump.

The pump is programmed with a wireless controller outside of the body. This enables you to administer medication at the moments when you need it the most. If you’re happy with the results, a permanent pump can be implanted.

Trial Periods

Both devices require a trial period before the procedures can be completed. It’s an unusual benefit: the patient actually has a chance to try out the new device before making a permanent decision.

The trial period lasts about a week. At that point, you and your doctor can assess whether there’s enough pain relief to warrant a permanent implantation. If you choose not to go forward, any material such as leads or implants are removed from your body.

The decision to have an implant as treatment can certainly be daunting. Most patients using these devices do experience some relief. However, neither is guaranteed to relieve pain for everyone who uses it. As with any internal device, there are potential downsides, and infections or complications can potentially occur. If there is a serious problem, the device can be removed at any time.

If you’re considering an implantable pain management system, you’ll want to thoroughly discuss the pros and cons with your doctor so that you’re as informed as possible. Give us a call at MidAmerica Orthopaedics at 708-237-7200 to find out more.