Spinal Cord Stimulators and CRPS / RSD

There is a big question as to whether a Spinal Cord Stimulator (SCS) is truly the great answer to CRPS / RSD pain that a lot of Pain Management doctors state that it is. 

There is literature and feedback on both sides of this debate.  Below is information on what a Spinal Cord Stimulator is supposed to do to help alleviate or decrease the pain for those that have CRPS or RSD. 



Unfortunately, what they don’t tell you is that there are also articles out there from Neurological Publications that the Neurosurgeons utilize that have shown studies where in some cases SCS have been known to cause the body to build up a layer of scar tissue around the leads or paddle of the SCS.  This same scar tissue then continue to grow around the Dura that protects the spinal cord, and if it is not caught it has been known to cause paralysis by putting pressure on the spinal cord.  Yes, you read that correctly!

Unfortunately, I have never heard of any doctors or representatives from the SCS companies ever mentioning this to their patients prior to having a Spinal Cord Stimulator implanted.  It is never mentioned with the possible risks. 

What is a Spinal Cord Stimulator?

When more conservative therapies have failed, the cost and risks of managing pain rise. Increasingly, many healthcare providers are employing a multi-modal approach to pain that includes spinal cord stimulation.

An implantable system delivers electrical pulses via a lead to nerves in the dorsal aspect of the spinal cord. Pain signals are inhibited before they reach the brain and replaced with a tingling sensation (parasthesia) that covers the specific areas where the pain was felt.

A spinal cord stimulation system consists of 2 implanted components:

·         Neurostimulator – Rechargeable or non-rechargeable implanted power source that generates electrical pulses according to programmable neurostimulation parameters and features

·         Lead – A set of thin wires with a protective coating and electrodes near the tip (percutaneous lead) or on a paddle (surgical lead). The electrodes transmit the electrical pulses to the stimulation site

Two external components to a spinal cord stimulation system allow the therapy to be customized for each patient:

·         Clinician Programmer – Used to program the implanted neurostimulator

·         Patient Programmer – Empowers patients by giving them a way to manage their pain relief – within preset physician parameters – to optimize outcomes

 

Other Information:

Prior to having the actual Spinal Cord Stimulator (SCS) implanted a patient will go through what they call a trial.  This entails having an external SCS set up with normally 2 leads that are surgically implanted at the correct level on the spine / vertebrae to reduce your pain.  The actual SCS itself is outside of your body and kept in a fanny pack that you have to wear, but it gives you an idea if this will work for you.

There have been some patients that have had a very successful trial where the SCS trial decreased their pain levels.  Only to have the real SCS that was implanted fail.

There are several manufacturers with this device, most of the time the patient does not have a say in what manufacture is going to be utilized.  The Pain Management doctor typically has their preference as to a specific vendor.  I highly suggest that anyone that is to the point of considering a Spinal Cord Stimulator to please do your homework.  Don't feel like you have to move forward with this just because your doctor has told your to or has suggested it.  There are other options out there to help decrease your pain, and once this has been done it is very difficult to un-do!

For additional information or if you would like to speak with me regarding Spinal Cord Stimulators please feel free to contact me at:  rsd.crpsforum@gmail.com.

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