An SCS is implanted in the body to produce electrical stimulation of the spinal cord from a small battery-powered generator attached to electrodes placed on the surface of the spinal cord, similar to a cardiac pacemaker. Its purpose is to block pain signals from getting through to the brain. They have been used for decades to help chronic pain patients and their use has grown, at least in the U.S., as a safer alternative to the use of opioids. Chronic pain is now said to be more prevalent than heart disease, cancer and diabetes combined and as many now die in the U.S. from opioids as in auto accidents. SCS users don’t always get good pain relief, but the majority who try it find it helps.
But use of SCS is not without some up-front risk. The implant involves a general anesthetic risk and a slight risk of spinal cord damage during insertion. Infection is always a risk, particularly when foreign material is implanted into the body. And if SCS stops giving relief, some patients find it bothersome enough to want it removed – another operation more risky than the first. The FDA has receivedabout 400 SCS injury reports per year over the last decade, with infection being the most frequent. Burning and painful shocking can also occur.
As with any medical procedure, the prospective patient must be fully informed of the benefits, risks, and alternative treatments before consenting to SCS. Opioids are not a good alternative for treating chronic pain. Also, some physicians have a financial relationship with either an SCS manufacturer or a hospital and don’t inform their patients. Even though they are not legally required to inform the person considering an implant, that would be the ethical thing to do.