A spinal cord stimulator is a device used to give electrical signals to the spinal cord to control chronic pain.  Basically, it works to interrupt pain impulses before they reach the brain, replacing them with a soothing feeling.  Some of the conditions that it is appropriate for include failed back surgery syndrome, back and/or leg pain in situations in which it has been determined that surgery is not likely to help significantly, complex regional pain syndrome, and refractory pain due to ischemia or neuropathy. 

To determine if this system will work a “test drive” or trial is performed.  This will generally take place as an outpatient procedure with sedation and local anesthesia.  After preparing the skin, and giving local anesthesia, one or two needles are placed in the back under X-ray guidance.  Once in place, leads are placed through the needles and guided with the use of X-ray up the spine.  Once tested for control of the targeted painful areas, these leads are connected to an external trial stimulator worn on a belt for a few days.  In that way, a patient can learn the extent to which the spinal cord stimulator can help control his/her  pain and improve the quality of his/her daily life.

The patient returns for removal of the leads a few days later. If the system helps one’s pain significantly, it can be implanted permanently so that there will be no need to wear an external belt.