Treatment information
Understanding your pathway
What is the treatment?
Spinal cord stimulation uses implanted leads and a pulse generator to deliver electrical stimulation near the spinal cord. It aims to alter pain signalling in selected chronic pain presentations. It does not repair the underlying spine. The system requires programming, ongoing follow-up and attention to device-specific restrictions. [1][2]
Who may be considered?
Selection usually involves specialist multidisciplinary assessment of persistent neuropathic pain after appropriate conventional treatment. Goals, psychological and practical needs, other options and the ability to manage the device are considered. It is not a routine treatment for every case of back pain, disc degeneration or pain after surgery. [1][2]
Assessment, preparation and consent
Before deciding, discuss your diagnosis, previous treatment, medicines and relevant health conditions. Tell the clinician about allergies, infection, blood-thinning medicines, diabetes and possible pregnancy. Do not stop prescribed medicines yourself. Ask what alternatives are available, including not having a procedure, and allow time to consider the benefits, uncertainty and risks that matter to you. [3]
What happens during treatment?
A trial is commonly used to assess whether stimulation produces a worthwhile change before a permanent implant is considered. A successful trial does not make implantation automatic or guarantee sustained benefit. The team reviews the trial, risks and your preferences before a separate decision about permanent treatment. [1][2]
Risks and safety considerations
Risks include infection, bleeding, spinal-fluid leakage, nerve injury, lead movement, device malfunction and possible further surgery or removal. MRI eligibility depends on the complete implanted system and specified scanning conditions. Do not assume any device is universally MRI-compatible; check with the implant team before a scan. [1][2]
Recovery and when to seek help
Follow the written instructions for transport, supervision, medicines, activity and driving. Recovery depends on the treatment and your health, so a fixed return-to-work date cannot be promised. Ask who to contact outside clinic hours. Seek urgent assessment for fever with worsening pain, new weakness or other unexpected neurological symptoms. Call 000 for breathing difficulty, collapse or another medical emergency. [4][3]
Expected benefit and limitations
Pain may improve, remain unchanged or worsen, and benefit can diminish. Removal is possible but involves another procedure and does not erase all surgical risks. Discuss maintenance, charging or battery replacement and activity restrictions. Follow-up assesses function and adverse effects as well as pain, with continued rehabilitation where appropriate. [1][2]
Follow-up and rehabilitation
Before treatment, choose a practical goal such as walking, sleep or a daily task. Record changes in that activity, pain and any adverse effects, then discuss them at follow-up. Ask what degree of change would justify further treatment and what would lead to stopping or changing the plan. Rehabilitation and self-management may remain part of care even if symptoms improve. [3][5]
Questions to bring to your appointment
Ask which structure is being targeted, why this approach is being considered and how strong the evidence is for your diagnosis. Clarify costs, the planned review date and any practical help you may need at home. Bring previous reports and your medicine list so the discussion can address your circumstances rather than a generic treatment pathway.
Sources and further reading
Sources support the statements cited above. Overseas guidance may describe different services or eligibility rules. A procedure leaflet explains a technique and its risks; it does not establish that the treatment is effective for every condition.
- Spinal cord stimulation — Leeds Teaching Hospitals NHS Trust
- Spinal cord stimulation: recommendations — NICE
- Procedures in pain medicine clinical care standard — Faculty of Pain Medicine, ANZCA
- Dorsal root ganglion / nerve root block / transforaminal injection — Hull University Teaching Hospitals NHS Trust
- Options for chronic pain management — Healthdirect Australia