One of the most significant drawbacks of spinal cord stimulation is that the therapy does not produce the desired results for everyone.

Spinal cord stimulation is considered successful if pain is reduced pain by at least half, but not everyone reaches that goal. With traditional low-frequency therapy, about 50% to 60% of those using spinal cord stimulation reach that goal, but studies have shown more than 80% experience significant pain relief when using newer, high-frequency therapy. 1 Kapural L, Yu C, Doust MW, et al. Novel 10-kHz High-frequency Therapy (HF10 Therapy) Is Superior to Traditional Low-frequency Spinal Cord Stimulation for the Treatment of Chronic Back and Leg Pain: The SENZA-RCT Randomized Controlled Trial. Anesthesiology. 2015;123(4):851-60. , 2 Deer TR, Skaribas IM, Haider N, et al. Effectiveness of cervical spinal cord stimulation for the management of chronic pain. Neuromodulation. 2014;17(3):265-71.


Device-Related Complications Common

Spinal cord stimulation and peripheral nerve field stimulation are considered generally safe, with the potential risks mainly related to the surgical procedures required for a trial period or long-term therapy.

One extensive study in the medical literature found 38% of the research participants had device-related problems. 3 Mekhail NA, Mathews M, Nageeb F, Guirguis M, Mekhail MN, Cheng J. Retrospective review of 707 cases of spinal cord stimulation: indications and complications. Pain Pract. 2011;11(2):148-53. The most common complications were unintended movement (also called migration) of the leads, failed connections in leads, and breakage of leads.

While complications related to the implanted devices are relatively common, they appear to be declining with advances in technology and surgeons’ skills. 4 Deer TR, Mekhail N, Provenzano D, et al. The appropriate use of neurostimulation of the spinal cord and peripheral nervous system for the treatment of chronic pain and ischemic diseases: the Neuromodulation Appropriateness Consensus Committee. Neuromodulation. 2014;17(6):515-50.

Serious Injuries Are Rare

The same study that looked at device-related problems also found that 12% of participants experienced pain at the site of the implanted generator right after surgery and 4.5% developed infections. 3 Mekhail NA, Mathews M, Nageeb F, Guirguis M, Mekhail MN, Cheng J. Retrospective review of 707 cases of spinal cord stimulation: indications and complications. Pain Pract. 2011;11(2):148-53.

See Scar Tissue and Pain After Back Surgery

Device-related issues are more common than physical problems. Serious adverse events, such as a hemorrhage in the epidural space or neurological damage caused by an injury to the nerve root or spinal cord—including paralysis—are not common. 5 Eldabe S, Buchser E, Duarte RV. Complications of Spinal Cord Stimulation and Peripheral Nerve Stimulation Techniques: A Review of the Literature. Pain Med. 2016;17(2):325-36.

Surgery Is Required

Both the trial period and insertion of most permanent spinal cord stimulation devices involve an implant and surgery. As with any such procedure, there are certain risks and potential complications, such as an infection and bleeding.

The recovery period is generally six to eight weeks, with some people experiencing intense pain for several days or more following either the trial period or permanent implantation of the spinal cord stimulation devices. Medication may be needed to control the pain.

See Recovery After Spinal Cord Stimulator Implant Surgery

While many generators can be recharged and used for years, if a new generator is needed, another surgery will be needed to remove and replace it.


Additional Disadvantages

Less serious disadvantages of spinal cord stimulation devices include:

  • Fluctuations in stimulation. Unwanted changes in stimulation may include a jolting or shocking feeling. The device should be turned off and the doctor contacted if this occurs.
  • Pain is not resolved. Spinal cord stimulation interferes with pain signals sent to the brain, but does not treat the underlying condition. People using this therapy need to continue working with others on their health care team.

    See Pain Management Specialists

  • Reaction to pressure. Those using spinal cord stimulation should not take part in activities that add pressure to the body. Scuba diving more than 10 meters below the surface should be avoided, and the doctor should be consulted before entering a hyperbaric chamber.
  • Electromagnetic interference. Strong interference, such as from a defibrillator or MRI (if the spinal cord stimulation device is not MRI-safe), can damage the generator, leading to severe burns, other serious injury, or death. Skin irritation may develop near the generator related to charging.

    See Important Considerations for an MRI Scan

  • Discomfort around generator. Some people find the implanted generator irritating or uncomfortable.

Relieving pain with spinal cord stimulation has some drawbacks. It is a different experience compared with painkillers or other pain control techniques. Learning as much as possible about spinal cord therapy can help a person decide on the best option to ease chronic pain in the back, neck, or limbs.

See Chronic Pain As a Disease: Why Does It Still Hurt?

Dr. Neel Mehta is an anesthesiologist and the Medical Director of Pain Medicine at NewYork-Presbyterian/Weill Cornell Medical Center. He specializes in treating spine and joint pain with minimally invasive, non-surgical procedures.

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