Does Spinal Cord Stimulation work?

[Bad Boy Bad Boy]

Sunshine, just be patient, Ask plenty of questions. If lost for questions, ask us here on what you could ask.

[Sunshine7]

Thanks BBBB for the support, have a nice evening.

[Sunshine7]

Sunshine7 Wrote:OOOOpppps didn't work, here ya go! Complex Regional Pain Syndrome (CRPS) and Spinal Cord Stimulator (SCS)
H. Hooshmand, M.D. and Eric M. Phillips
Neurological Associates Pain Management Center
Vero Beach, Florida
Abstract. The following is a summary of our experience with treating complex regional pain syndrome (CRPS)
patients who have undergone spinal cord stimulator (SCS) treatment for one year or longer. The success or failure of
the treatment with SCS depends on how early in the course of the illness the SCS treatment started, and depends on the
nature of the original nociceptive pain.
Descriptors. complex regional pain syndrome (CRPS), failed back syndrome (FBS), failed neck syndrome (FNS),
infrared thermal imaging (ITI), spinal cord stimulator (SCS).
INTRODUCTION
Spinal cord stimulators (SCS) are effective in treatment of somatic chronic pain (e.g., failed back syndrome
(FBS) and failed neck syndrome (FNS)) but it does not help CRPS patients. Usually, the beneficial effect of SCS in
management of CRPS is brief (a few weeks to a few months in more than 70% of patients). The SCS as a foreign
body, may aggravate the CRPS pain, cause vasoconstriction, and inflammation in late stages of CRPS. Interferential
surface skin stimulator, a modified form of transcutaneous electrical nerve stimulation (TENS), is a good noninvasive
substitute.
In our experience, the type of patient that we see in our clinic is different from most other centers. The
patients that end up in our clinic have been to primary, and secondary referral centers. We are a tertiary center of the
last resort where late stage CRPS patients are treated. Most of the patients that we receive already have had on the
average of one to two surgical procedures, e.g., carpal tunnel syndrome and SCS treatment, and in many cases more.
The majority of the cases who have had SCS treatments have had the original invasive procedure plus revisions,
replacements, or the adjustments of the position of the electrodes, etc.
To begin with, we have to divide the effect of CRPS into two separate types of nociceptive pain, i.e.,
somesthetic pain such as FBS, versus neuropathic pain such as CRPS. The neuropathic pain has a neurovascular
component to it whereas the somesthetic pain usually does not have a neurovascular component.
SCS is a digital stimulator utilized for treatment of an analog symptom (the analog pain modality is random
and not time locked or digital). It is not a type of treatment that would be successful in every form of chronic pain.
In CRPS, the immune system is rogue. This is because the immune system is modulated by the sympathetic
system. The sympathetic system, under pain input, responds by releasing T-cell lymphocytes (in early stages CD4 or
helper lymphocytes, and in late stages CD8 or killer T-cell lymphocytes)(1,2). So, after the SCS has lost its effect, the
sympathetic system considers the foreign body of the SCS as a source of sympathetic dysfunction. This causes
neuroinflammation manifested as skin rash, edema, and infection(1,3).
1

I have decided against it to many complications, thanks for everyones reply ur great!

[Bad Boy Bad Boy]

You can ask for an external unit. SCS depends on how early in the course of the illness the SCS treatment started, and depends on the
nature of the original nociceptive pain.

[AQA]

I think I would go through the trial period. That way you would know for sure if it is going to work or not. The trial period last a week and it is all external except for the ends of the leads. If there is not atleast a 50-60% improvement in the pain level, the dr. will not request a permanent one.

Just my thoughts and experience.