My Experience With a Spinal Stimulator for Chronic Back Pain

One of the worst parts of my chronic pain is my chronic low back pain. Whether due to my psoriatic arthritis (PsA), my degenerative disc disease, my sacroiliitis, or a combination of the three, my low back pain has been severe since my PsA diagnosis. While I take infusions for my PsA, and pain medications for the accompanying pain, none of it fully addresses what I experience with my back pain. I have done physical therapy, massage, pool therapy, and everything I could think of to treat my back pain, to no avail. Finally, an orthopedic surgeon I was seeing recommended I ask my pain clinic about a spinal stimulator.

A spinal stimulator is a medical device implanted to treat severe back and leg pain. It involves surgically implanting electrical leads into the epidural space of the spine, which is between the dura matter (the outer membrane surrounding the spinal cord) and the ligaments inside the spine. The leads are connected to a battery and send electrical pulses into the spine that translate the pain signals to the brain into different types of signals. Older models would turn those signals into feelings of tingling, but newer models simply cut the signals out so one doesn’t feel pain or tingling.

The process to get the spinal stimulator involved getting a referral from my pain clinic to another pain clinic in a different city because it is the only clinic nearby that implants the type of stimulator that will meet my needs. As it was explained to me, most people who receive spinal stimulators also have pain radiating into their legs, but since my pain is mainly located in my low back (I do get some numbness and tingling down my legs, but not the same type of pain I feel in my back) there is only one or two brands of stimulators that are right for me. I met with the doctor at the clinic who recommended a series of epidurals to try to treat my back pain before jumping into the spinal stimulator trial.

I received epidurals every week for a month, and received no relief from the spinal injections. After a month, I followed back up with the doctor who recommended the trial based on the lack of success of the epidurals. But first, I needed a psychological evaluation.

I met with the psychologist at my regular pain clinic for a thorough interview regarding my expectations for the trial (my regular pain clinic is equipped to do the spinal stimulator psychological testing no matter where the device itself is put in). The trial isn’t always successful, and even if it is, it isn’t a guarantee that the spinal stimulator itself will be successful. It’s important to be hopeful, but not to have your expectations too high when considering the spinal stimulator. The psychologist explained the procedure to me, and showed me some sample stimulators and batteries. I also had to take a personality assessment. I was also warned that individuals with depression and anxiety typically had a lower success rate with the stimulator. As someone who has struggled with depression and anxiety since middle school, it is something serious to take into consideration when building hope and expectations for the success of the spinal stimulator.

I was then scheduled to have the trial stimulator put in. I was given an IV and medication to put me in a twilight-type state. I do not remember actually having the stimulator put in because of that medication. However, it was fast-acting, and soon after I was ready to go. I spent a week with the stimulator in place. The first couple of days were very painful, as my body was adjusting to having the procedure. The actual device was the electrical leads in my spine sticking out of my back, connected to a battery that was taped to my back. I also had a remote that controlled the battery pack and the level of electrical stimulation I received.

I received a call every day from the representative of the device company, and they asked about my pain level and helped me adjust the level of stimulation I received with the remote. I had to give them a percentage of relief every day, and 50% relief is considered a success. I ended up increasing the level of stimulation twice. The device itself hurt throughout the week, but I was able to differentiate between pain from the device itself and my chronic pain. It was explained that oftentimes younger people have more pain from the device because their back muscles that the wires go through are stronger, and there are more layers of muscle that the wires have to stick through.

My chronic pain, however, was almost completely gone. By the end of the trial, while I was relieved to get the device out, I was disappointed that my chronic pain had to return. I am now looking forward to getting the permanent device implanted, as my trial was deemed a success. I am now awaiting an appointment for a lumbar spine MRI before scheduling with the surgeon who will implant the permanent device. The trial was a positive experience overall, and I am glad I went through it. Now I am looking forward to the next steps.