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SCS, At what point to you ask for one

grandmesamomggrandmesamom Posts: 181
edited 06/11/2012 - 8:39 AM in Spinal Cord Stimulation
Hi, I have recently been reading up on SCS as I didn't even know it existed.
I have chronic radiculapathy and weakness to my left arm as well as deep pain in my right arm. This is all caused from a cord compression and i have had 2 separate cervical fusions. I have been in chronic pain for the last year. My arms hurt constantly. I have been on lyrica with initially satisfactory relief but now that does not seem to help. My quality of life is becoming worse and I cry everyday. I have norco and muscle relaxants with minimal relief. I don't want to take these meds anymore. All they do is make me tired. I continue to work full time and i want to work. I wonder why SCS has never been suggested to me before. My Physiatrist manages my pain meds now. When I try to tell her how bad my arms hurt she is sympathetic but doesn't want to make any changes.
At what point do you ask to try SCS and does it work for cervical pain. i ask this question because it seems to refer to lumbar pain more often. Does this work like a TENS unit? I had a TENS unit 10 years ago for a lumbar issue and it was very effective.
I have never been referred to a pain DR but I don't want anymore meds to make me groggy. Do you think its worth asking about this and who would I ask?


  • If you have had some relief from Lyrica, maybe you can mention to your Doctor that it doesn't seem to be cutting it all the way anymore. There are other nerve drugs that can be taken such as Neurontin, Cymbalta, Topomax, Sevalla, to name just a few. An SCS is a huge commitment and should be tried when all other measures have been exhausted. I know its frustrating but you should open a dialog up with your Doctor and let him/her know you are willing to try other things to get your pain under control.

    I recently had my permanent SCS implanted. It hits most of my discomfort but not all of it. I will always have to take some sort of pain medication and muscle relaxers for my problem. The SCS just helps me reduce my current dosage and buys me time.

    An SCS may be in your future but I would at least try to exhaust all other avenues before I went down that road. Just my two cents.

  • medtronic is one of the companies that makes the neurostimulators. their website mentions low back and leg pain, but doesn't talk about cervical pain or arm pain: https://www.medtronic.com/our-therapies/neurostimulators-pain-conditions/index.htm
    but, i didn't read through the whole thing....

    definitely speak to your physiatrist. a good interventional pain management doctor will have many tricks in his bag other than pills. if the physiatrist doesn't have more to offer you, try a different doctor. they all have their preferred methods of dealing with particular types of pain.

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  • I had the fusion and laminectomy b/4 I was sent to see somone about a SCS. That is to say 1. I had not found any drugs that I could tolerate. 2. I was experiencing a lot of pain and a very poor quality of life, The SCS was introduced to me by my crazy spine surgeon. All of this is to say that spinal cord stimulation is a method of last resort. So, first you have to try that Lyrica or Savella or whatever. When I talked to the ANS rep who I dealt with after my lst SCS trial, I asked "Could I have gotten this w/o my failed surgery. He asnwered, "Probably not." But, the times, they are a changin'" so it could be different. I think I would have opted for the SCS over lami and fusion any day.

    BUT I am FBSS. So, I might feel differently if I were a surgical success (and if my surgeon weren't such an expletive.)

    With the SCS, you have nothing to lose and you will have a trial for 5 to 7 days to see if it helps. You don't get that kind of "trial" with other products.

    My surgoen believed that a TENS unit was very similar to a SCS and so he arranged for me to use a TENS unit for period of time. I hated it! But, I insisted on continuing the plan for me to try a spinal cord stim. I LOVED It!
  • In my opinion, the point at which you consider the SCS is the point when there's absolutely nothing else left to consider, except possibly the implanted drug pump.

    The SCS can be used for cervical issues, but whether or not it works really depends on the patient. Only the trial will give a definite answer to that question. The SCS is one therapy that is truly not a cookie cutter approach and doesn't work the same for everyone, even if their initial presentation and history is nearly identical.

    The problem with going to the SCS before you've exhausted all of the surgical options and corrected all the structural/mechanical issues is that those issues continue to cause damage to the nerves involved. Eventually the pain from the ongoing damage will reach a level that the SCS can't compete with.

    It's just like taking care of your house. If it rains and you notice a water stain forming on the plaster of your ceiling, would you just paint over the stain? Probably not, because we know that if we ignore the hole where the water is coming in, eventually the entire ceiling is going to fall in on our heads.

    The SCS is just paint over a water stain. If we don't fix all the structural problems first, eventually something is going to come crashing down on our heads and at that point, the problems may be well beyond any hope of repair. :(
  • At what point do you ask to try SCS and does it work for cervical pain.
    In answer to the question about whether an SCS works for cervical pain, yes it can. My SCS is in my c-spine and does a nice job of helping out.

    At what point do you ask for an SCS, well that's a personal choice. If your doc doesn't present it as an option, then the doc either doesn't feel you're a good candidate, or the doc isn't familiar with spinal cord stimulation.

    As more people discover spinal cord stimulation via the Internet and by word of mouth, it certainly can seem like the next best thing, or the latest and greatest. To someone in pain it seems like the light at the end of the tunnel.

    While spinal cord stimulation can and does help many people better manage their pain, it does come with a pretty hefty responsibility that many people in retrospect wish they hadn't taken on.

    If there is still a chance that your pain can be managed effectively via medications and further surgery, it's really something that should be considered strongly, before jumping to "implant status". If you are currently capable of working full time despite your pain and medication issues, that really should weigh heavily in the decision making process.

    A large part of the goal in spinal cord stimulation, is to regain functionality. So the amount of current functionality should really be considered.

    Spinal cord stimulation is not the "magic pill" that many pain patients so desperately seek. There's a lot of evidence of that here on Spine Health.

    My c-spine SCS helps me to function but limits me on many things. If there was an alternative way to treat my pain issues that gave me the same or better functionality, I'd take that in a heart beat.

    It never hurts to approach the subject with your doc and see what kind of reaction you get. It's all a part of being your own personal advocate.


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  • I have one Cervical lead for arm/shoulder pain.
    As has been expressed above, exhaust all other options as the SCS is a commitment.
    You will have the trial, there's a topic here on that.
    You will have to learn to deal with charging, using the remote and eventually you WILL have MORE surgery. The rechargeable batteries are supposed to last about 9 years IIRC. so the implant will have to be swapped out at that point.

    There is also the chance the SCS will only help part of your pain and you will still be on meds for the rest. It is actually more normal for an SCS user to still take medication of one form or another than to be able to stop all meds.

    That being said, it can be life changing. for the better.
  • I agree with everyone here. I was in pain so long and no one knew what to do...finally my ob/gyn said I needed to see a pain managment doctor. He referred to and from there it was a cake walk. I didn't have to go through a psych elav. I don't know why some doctors demand that and others don't. I would be honest and tell your doctor(s) that the current medications are not working and ask what other options are out there. You doctor may not know much about SCS or think your condition is suited for the SCS. All you can do is talk to your doctor and see what they say. If you are wanting more information you can go to the sites of ANS, Boston Scientific, Medtronic, or any other company out there that I didn't list, and get information sent to you. I think I got them all but I may be mistaken, and they are in alpha order so please no one think I am for one over the other. I wouldn't promote one brand over the other as I am not a doctor and do not know the advantages of one over the other.

    Like everyone has said it works for some people and others it doesn't. I am lucky that it has taken care of most of my pain and I have been able to reduce my meds to a point of almost taking nothing at all. It is life changing...some for the better and some just changing.
  • Thanks for your comment. I am working full time but on self imposed light duty. I am very fortunate that my corporate ofice is in another state and I can adjust my schedule and work load according how i feel.My functionality is poor compared to where I was one year ago.
    I hate the lyrica,muscle relaxers and norco I take. It makes me so foggy and tired.The SCS peaked my interest because I was hoping to get off of all medications.
    I will ask her the next visit as she is helping me cover up my disability at work. I need to provide for my sons.
    Sometimes things sound great on paper so I am happy to hear everyones comments about SCS.
    I was offered injections but refused. I had them in my back years ago and they did nothing for me.
    All they seem to offer me is drugs and I tolerate them poorly.I want to be awake and alert!
  • Your comments are encouraging and I am willing to try anything at this point.
    I did like my TENS unit for my back years ago and this sounded similar.
    I have heard about pain pumps also.
    Why would a Dr choose a pain pump over a SCS?
  • I hate the lyrica,muscle relaxers and norco I take. It makes me so foggy and tired.The SCS peaked my interest because I was hoping to get off of all medications.
    Well the SCS is not a true "drug eliminator", in fact it is more of a "drug manager". I still require Neurontin, Celebrex and Zanaflex in conjunction with my SCS.

    Pain Pumps fall into play even further down the road than spinal cord stimulation. They came about, for treating cancer patients, where the idea was to improve the quality of life, for what life was left. It was then adapted to treat chronic non-cancer pain in cases where the amount of narcotic needed and side effects became a losing battle. Pain pumps are as I believe Meydey put it, "a marriage to your Pain Management doc". The restrictions, hazards and limitations are quite eye opening and it is not something to blindly walk into.

    Pain Pumps also tend to be more effective for pain that is not necessarily nerve based and in some cases non-specific. So in cases where spinal cord stimulation is ineffective, a pain pump can be of help.

    Any implantable system should not even be considered until all other options have been tried or considered. Like BionicWoman pointed out, you don't throw fresh paint on water stains, without first finding the leak and repairing it.

    Hope you find some relief somehow.

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