Any significant local pain should be reported to the doctor. The site on the back where the leads and electrodes were inserted is usually uncomfortable for a few days. If the pain is not relieved, the doctor should be contacted right away so the device can be reprogrammed. The doctor may ask the patient to track which stimulation settings are used at different times and how well the pain was relieved.With some models, adjustments are needed for significant body movements, such as getting up or lying down. The controller offers a range of adjustments in the intensity and duration of stimulation. The patient is given the controller and can turn it on to send pulses of current to the electrodes as needed.A hand-held controller to adjust the amount of stimulation is programmed by the doctor based on the earlier feedback from the patient during adjustment of the electrical contacts. Dorsal Column Stimulator A Patients Guide to Pain Management: Spinal Cord Stimulators (Dorsal Column Stimulators) Introduction A spinal cord stimulator, also called a dorsal column stimulator, is an implanted electronic device used to help treat chronic pain.The patient is given time to recover from the procedure before going home.See Rechargeable Spinal Cord Stimulators for Chronic Pain The wire connecting to the external neurostimulator is taped to the person’s back during the trial to hold it in place. The leads are connected to an exterior pulse transmitter that the patient wears on a belt.Once the patient has reported on the pain-relief coverage, the patient is again sedated. Devices using newer technology generally avoid the tingling sensation and a wake-up test may not be needed.) Each electrode affects pain in a different area, so doctor-patient communication is crucial in making sure the doctor has adjusted the location of the electrical contacts to cover all the areas in pain. (If a low-frequency system is used, the goal will be to cover all painful areas with a slight tingling sensation known as paresthesia. The patient is awakened to provide feedback on the specific areas where pain is relieved by the stimulation, and where pain relief is still required. Present and potential use of spinal cord stimulation to control chronic pain.See Introduction to Diagnostic Studies for Back and Neck Pain In some cases, a small incision may be needed to insert the needle. When turned on, the SCS stimulates the nerves in the area where your pain is felt. Thin wires carry current from a pulse generator to the nerve fibers of the spinal cord. The needle contains thin, insulated wires, called leads, with electrical contacts attached. A spinal cord stimulator (SCS) device is surgically placed under your skin and sends a mild electric current to your spinal cord (Fig. Guided by fluoroscopy (a type of X-ray), the doctor inserts a hollow needle into the area around the spinal canal called the epidural space.Local anesthesia is applied to the injection site and sedation may be provided.Procedures vary somewhat with the stimulation device used, but these are the typical steps. The trial period procedure is usually performed in a doctor’s office or a surgical center.
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