Can Spinal Cord Stimulator Make Pain Worse?
The spinal cord stimulator (SCS) is a widely used medical device for treating chronic pain, particularly in cases of failed back surgery syndrome, complex regional pain syndrome, and chronic radicular pain. Despite its effectiveness in many patients, there is growing concern about the potential for the SCS to make pain worse in some individuals. This article aims to explore the reasons behind this concern and provide insights into the factors that may contribute to this phenomenon.
Firstly, it is important to understand how the spinal cord stimulator works. The device consists of a pulse generator that is implanted under the skin, typically in the upper buttock area, and electrodes that are placed near the spinal cord. These electrodes deliver electrical impulses to the spinal cord, which can block pain signals from reaching the brain. While this process is generally effective, there are instances where the SCS may exacerbate pain.
One possible reason for the worsening of pain with an SCS is improper placement of the electrodes. If the electrodes are not correctly positioned, they may not effectively block the pain signals, leading to a perceived increase in pain. Additionally, the placement of the electrodes too close to sensitive areas, such as the spinal cord itself, can cause discomfort or pain.
Another factor that may contribute to the worsening of pain is the programming of the SCS. The device’s settings, such as the intensity and frequency of the electrical impulses, can be adjusted to optimize pain relief. However, if the settings are not properly calibrated, they may inadvertently cause discomfort or pain instead of relief. In some cases, patients may require frequent adjustments to find the most effective settings.
Furthermore, some individuals may experience side effects from the SCS, such as tingling, numbness, or discomfort at the electrode site. While these side effects are generally temporary, they can contribute to the perception of increased pain. Additionally, the device itself may cause discomfort due to its placement under the skin, especially during the initial healing period.
It is also worth noting that the effectiveness of the SCS can vary greatly among individuals. While some patients experience significant pain relief, others may not see the same benefits. In some cases, this discrepancy may lead to frustration and a perception that the SCS is making their pain worse.
To address these concerns, it is crucial for healthcare providers to carefully select candidates for SCS implantation and ensure proper placement and programming of the device. Regular follow-up appointments are essential to monitor the patient’s response to the SCS and make necessary adjustments. Additionally, patients should be educated about the potential risks and benefits of the procedure, as well as the importance of open communication with their healthcare providers.
In conclusion, while the spinal cord stimulator is a valuable tool for managing chronic pain, there is a possibility that it may make pain worse in some individuals. This can be attributed to factors such as improper placement of electrodes, inadequate programming, side effects, and individual differences in response to the device. By addressing these concerns and providing appropriate care, healthcare providers can help ensure that patients receive the maximum benefit from their SCS while minimizing the risk of worsening pain.
