What Is Spinal Cord Stimulation?
Five decades of clinical use. One consistent goal: lasting pain relief without surgery or drugs.
Years of Established Clinical Use
Spinal cord stimulation has been used to manage chronic pain for more than five decades, making it one of the most studied and refined neuromodulation therapies in medicine. Over this time, device technology, waveform options, and patient selection criteria have all advanced dramatically.
Leads Placed in the Epidural Space
One or more thin, flexible leads are implanted in the epidural space, the narrow corridor between the spinal cord and the vertebral bones. These leads deliver precise electrical impulses to the dorsal columns, modifying the way pain signals travel between the body and the brain.
Adjustable, Programmable, Reversible
Patients control the device using a handheld programmer, adjusting stimulation intensity and switching between settings as activity level and pain change throughout the day. The therapy is fully reversible. The device can be turned off or removed at any time without permanent consequences.
The Science: How SCS Interrupts Pain at the Neurological Level
Early SCS systems worked on the gate control theory of pain, where non-painful electrical stimulation activates large-diameter sensory fibers, closing a neurological gate that would otherwise allow pain signals to ascend toward the brain. Today’s modern systems go further. High-frequency and burst stimulation waveforms produce pain relief through distinct mechanisms including direct effects on dorsal horn neurons, glial cell modulation, and activation of descending inhibitory pathways. Neuroimaging studies confirm that SCS produces measurable changes in cortical activity. This is genuine neurological pain modulation, not distraction or placebo.
Four Waveforms. One Device. Personalized Relief.
Today’s SCS platforms offer multiple stimulation modes, each with distinct mechanisms and clinical applications.
Tonic Stimulation
ClassicHigh-Frequency (10kHz)
Paresthesia-FreeBurst Stimulation
Axial Back PainSub-Perception
No SensationWhen Is Spinal Cord Stimulation Recommended?
SCS is a second or third-line therapy for treatment-refractory chronic pain with specific indications.
Spinal cord stimulation is typically considered when chronic pain has persisted despite an adequate trial of conservative management, including physical therapy, medications, and targeted injections or nerve blocks. Common clinical indications include:
Failed Back Surgery Syndrome
Persistent pain after technically successful spinal surgery, particularly leg-dominant radicular pain.
Complex Regional Pain Syndrome
CRPS Types I and II with documented autonomic and neuropathic features.
Painful Diabetic Neuropathy
Refractory lower extremity neuropathic pain from diabetic peripheral neuropathy.
Chronic Back and Leg Pain
Degenerative spine disease producing axial back pain and/or radiculopathy not resolved by other means.
Post-Herpetic Neuralgia
Persistent neuropathic pain following shingles infection that has not resolved with medications.
Ischemic Limb Pain
Chronic pain from peripheral arterial disease or inoperable coronary artery disease.
The Trial and Implant Process
Every SCS journey begins with a trial that lets you experience the therapy before any permanent commitment.
Comprehensive Evaluation and Patient Selection
Your CURA physician reviews your full pain history, imaging studies, prior treatments, and physical examination. Psychological screening is completed. The goal is to confirm that your diagnosis is appropriate for SCS, that conservative options have been adequately trialed, and that your expectations are realistic.
Trial Lead Placement Under Fluoroscopic Guidance
Temporary leads are placed in the epidural space under real-time fluoroscopic imaging and positioned to cover your specific pain distribution. The leads connect to an external pulse generator worn outside the body. The trial typically lasts 5 to 10 days during your normal daily activities.
Trial Assessment: The 50% Threshold
If the trial produces at least 50% improvement in pain intensity or functional ability, you are considered a successful responder. Your physician will review your pain diary, functional assessments, and overall experience before recommending proceeding to a permanent implant.
Permanent Implant and IPG Placement
Definitive leads are placed at the same target levels, and a small implantable pulse generator is placed subcutaneously, typically in the upper buttock or lower abdomen. The procedure is performed on an outpatient or short-stay basis. Most patients return home the same day and resume light activity within a few days.
Programming, Optimization, and Long-Term Care
After implantation, your CURA physician works with you to fine-tune stimulation parameters including amplitude, frequency, pulse width, and waveform selection. Programming is adjusted over time as your pain pattern evolves. The IPG battery typically lasts 5 to 10 years depending on usage, after which it can be replaced in a brief outpatient procedure.
Frequently Asked Questions
Common questions about spinal cord stimulation answered by our board-certified specialists.
Spinal injections deliver anti-inflammatory medication to a specific anatomical target and provide temporary relief that typically lasts weeks to months. Spinal cord stimulation does not involve injecting medication at all. Instead, it modifies the way the nervous system processes pain signals on an ongoing basis through electrical impulses. SCS is a longer-term solution intended for patients whose pain has not been adequately controlled by injections and other conservative therapies.
It depends on the waveform used. Traditional tonic stimulation produces a mild tingling or buzzing sensation called paresthesia in the area of pain. Many patients find this reassuring as confirmation the therapy is working. High-frequency and sub-perception waveforms, however, produce no detectable sensation at all. Your physician will work with you to find the setting that provides the best combination of relief and comfort.
Most modern SCS systems are conditionally MRI-compatible, meaning that MRI scans can be performed safely under specific conditions and settings. The exact parameters depend on the device manufacturer and model. Your CURA physician will discuss the MRI compatibility of the specific device being implanted and ensure that any future imaging needs can be accommodated safely. This is an important factor to discuss before proceeding with implantation.
For well-selected patients, SCS provides sustained pain relief that has been documented in long-term studies extending beyond 5 and 10 years. Unlike injections, SCS relief does not wear off over weeks. The device remains active as long as it is powered, and stimulation parameters can be adjusted over time as pain patterns evolve. The IPG battery lasts 5 to 10 years depending on usage settings, after which a minor replacement procedure restores full function.
Yes, SCS is covered by Medicare and most major commercial insurance plans for appropriate indications, including failed back surgery syndrome, complex regional pain syndrome, and other documented refractory pain conditions. Coverage typically requires evidence of an appropriate diagnosis, documented failure of conservative treatments, a successful trial stimulation period, and psychological clearance. CURA’s team handles comprehensive insurance verification before proceeding so you have full clarity on coverage and costs.
The mandatory trial period exists precisely to answer this question before any permanent commitment is made. If the trial does not produce adequate improvement, no permanent device is implanted and the temporary leads are simply removed. If a permanent device is implanted but over time provides insufficient relief, stimulation parameters can be reprogrammed, waveforms can be changed, and if necessary the device can be explanted. SCS is a fully reversible therapy at every stage of the process.
