for me, the insertion surgery was really easy.
i have had a few battery changes, as i do not have a rechargeable unit.
the battery change surgery is mildly uncomfortable for me.

Sixty percent pain reduction translates to a pain number of 9 to a pain number of 3. Sixty percent looks different when couched in those terms.

i still need opioid therapy, but far, far less.

this discussion opened a very-long time ago.

perhaps it would be easier to follow if someone were to open a new discussion and take it from there.

Mike, you can click on my little picture and read a little about me.

Well, I saw some recent posts within the last couple of weeks, so thought I'd just keep it "alive" for anyone out there still that are considering SCS as an option, they can read through all the pages in one place to find out different opinions on the subject.

I certainly hope I have the same success as you and others here have as well. My pain is not as severe; at worst I'd call it a 7, but bad enough that I was willing to give this a shot. My PM Dr. and I discussed it and determined this would be my best option. The medications worked as well as the blocks, but to me, that is a hassle considering the SCS, and detrimaental to my career. At worst, I'll be able to decrease my dependence on medication, and for sure, that medication will not be a scheduled narcotic, which was the main determination for me to go through with it after the trial.

I, unfortunately, cannot tolerate antidepressants, though they worked. I can tolerate neurontin at lower doses, so long as I won't be tied to it on a daily basis, only when my pain is at its worst, I expect. The large doses prevented me from functioning, though I required large doses to alleviate the pain when taken daily, as my tolerance for neurontin grew quickly, within a couple of months. I have, however, determined that I can take the neurontin at fairly low doses (300-600mg/dose) and it works wonders, so long as I do not need to take it on a daily basis, which is where the SCS comes in. During the trial, the SCS knocked out a large portion of my worst pain (which comes and goes on a whim) and the 24/7 persistant pain was knocked out nearly completely. I could live with the "left over" pain when it gets bad, though with the neurontin, I can get nearly complete relief. I'll discuss w/ my PM doc next appt in a couple of months. Regardless, that's a far cry from taking multiple doses of scheduled narcotics daily. I'm thankful that I had that option; I realize many here do not.

Anyway, a question for you...are you able to switch to a rechargable IPG the next time you go in for a replacement? Or is there a specific reason you have the non-rechargable type? I am thankful for having a rechargable battery so I can avoid getting a replacement for potentially 10 years. Regardless, my recovery from this implant is worst at the laminectomy site, not the IPG site, so I see what you are saying about it not being a huge deal. I certainly would not want to go through this laminectomy every few years, but the minor "stinging" pain at the IPG incision point would not take more than 3-4 days to recover from. When you have your battery replaced, are you required to go under general anesthesia, or can they give you light sedation for that? That is something I'll have to ask my rep as well.

Best wishes for you, and I really appreciated your take on the SCS as I think you presented a much more reasonable light on the SCS than the "doom and gloom" scenario that I've read which I feel is an unfair characterization of the SCS option.

Beth,

I wasn't given a choice about recharge or non recharge.. I got injured at work have had a spinal fusion at l3/4 that failed. I am sure you know the routine. Anyways, have you heard of anyone that has issues with the rechargeable battery. I was told that I could plan to sit up and recharge the battery for a few hours. I was not told until recently and after it was implanted how often I would have to do this. Needless to say I am a very unhappy camper. My battery will not recharge unless I am standing or walking.. Which who in their right mind is going to walk around for 4 hours with a huge magnent attached to their bum.. Or the fact that I can not walk 4 hours straight. Heck I can not tolerate even walking 30 minutes straight. It will also recharge but is extremely positional if I lay on my right side to charge it. The battery is located on the left side. This is so not what I was told to expect. It does help with the leg pain and bladder issue. However the leg pain comes back with Physical therapy. So I feel as though I can not win. Any information you could share with me would be appreciated it. Thank you Tina

Hey Beth,
I'm getting used to this charging scenerio too. Mine is extremely sensitive. Mine is on my left buttock. I get in a comfortable position, lying on my right side, with about 3 million pillows, (ha) and then....stay patient and put the smooth side of your outside charger against your skin and move it in small little steps until you have a connection. Does your charger show....bars for example colored in, when you have connected? If so, try to find a spot where you can get the most....remember against the skin, and lying down. Once you find an area even if it's just half the bars, hold it real still, and pull your underwear up to hold it in place, so much easier than trying to use the velcro belt! Just be patient with it, it may take a time or two. Call the rep guy if it gets too low, because if it drains completely out, sometimes it has to be replaced altogether. I have Medtronic, which so far, so GOOD!

Good Luck,
Kristin

The success rate for the SCS and the IT pump is around 60% at 12 months (see: http://www.painphysicianjournal.com/2009/july/2009;12;699-802.pdf ). This research is the most comprehensive contemporary research for all major spinal interventions.

Since surgery is required to implant and to remove the devices, and since all surgery entails morbidity, this is not a decision to be made lightly. Some pain patients have developed MRSA infections and died from the procedures.

Even if the surgery is successful, there is no guarantee that it will remain that way. If the lead moves a fraction of a centimeter away from the spinal nerve root, or if the catheter (from an IT pump) moves a fraction of a CM away from the sweet spot, the result is a huge increase in pain and an implanted medical device that requires more surgery to remove.

In today's world of surgery, 60% is not a very viable outcome. You can have Lasik at 96%, an appendectomy at 95% and a knee replacement at 90%. So 60% represents a bad outcome.

The SCS and the IT pump are for those chronic severe pain patients who cannot benefit from; or who have had severe side effects from all of the medications that can treat chronic pain. Far too many patients try three or four of the dozens of medication combinations and then request surgery to implant a device with a poor track record. In fact, they should take the time to try all possible medication combinations. This includes long and short-acting opiates, anti-depressants, anti-convulsants, anti-inflammatories and mind-body treatments like biofeedback, systematic relaxation, acupuncture and meditation. Even hypnosis can be tried before having surgery to implant a mechanism with a poor track record for success.

It can take years to try all possible combinations of medications. But if you find the best combination for your unique body chemistry, then you won't need to try risky surgery to implant the SCS or IT Pump.

A couple of arguments to your post:

First, as I've already mentioned in an earlier post, this research you are touting is already three years old, with many of the supporting articles for this study being from the 80s, 90s, and early 2000s. Many technological improvements have been made to the SCS system since then, so your 60% success rate number is old not a reliable statistic.

Second, MRSA can be contracted in various ways, so to somehow attribute this infection to SCS surgery is misleading. Yes, there are risks w/ surgery, but the risk of dying from SCS surgery is a risk just like the risk of dying from Liver damage caused by continued use of many medications used for pain management. There are also risks associated with deaths caused by Opioid overdoses A CDC study from 1999-2008 points to the ever increasing deaths caused by Opioid overdoses. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6043a4.htm
Many of these deaths, I'm sure, are from illegal users, but the threat remains for pain sufferers as well, and is a risk that must be weighed as well.

Your point about leads moving is also not completely accurate. Many leads are affixed to vertebrae and will not move outside of a experiencing extreme trauma or force. Additionally, this claim: "moves a fraction of a CM away from the sweet spot, the result is a huge increase in pain and an implanted medical device that requires more surgery to remove" is highly sensationalized and inaccurate. Have you personally experienced this complication?

This statement: "The SCS and the IT pump are for those chronic severe pain patients who cannot benefit from; or who have had severe side effects from all of the medications that can treat chronic pain" is also not accurate. The pain medications I was on were beneficial, and while some I tried I was unable to tolerate, I did find a combination that did work fairly well for me. I chose to go through with this procedure because it provided the BEST option for me and not for any other reason. Pain medication greatly restricts my ability to serve in the military, and while the SCS will to a point, as well, it will not restrict my service nearly as much. And to advise patients to try all possible medication combinations is irresponsible. Only a PM Dr. should be advising a patient on treatment options. If you want to provide a list pain management treatment options that may be beneficial for a patient to discuss their PM Dr., then that is different. Many of these options, BTW, are not covered by insurance, so because patients don't try these options first does not make them wrong for going through with the SCS option.

Again, I will not speak to the IT pump, as I have very limited knowledge of this device, but also again, it is a viable treatment that a patient can discuss with their PM Dr.

Bottom line is, you are advising people here on this forum not to try a viable treatment plan until they try the options YOU think are better; one that I'm pretty sure you have no personal experience with, and I take issue with that. Not even the Drs. here, the expert opinions, would dare to try to convince members here to try or not try an option. If you simply pointed out that, while you don't have personal experience with these options, but have looked up some research on them and you have some concerns with these options, and you personally would not try these options yourself, that would be one thing, but you have taken it a step too far, IMO, by using sensationalist language and throwing words around like morbidity and MRSA and making generalizations like a bunch of patients try a few medications and request an implantable device, which you have no basis for making that assertion and is an unfair characterization of those of us that chose, through discussions with our PM Drs., to go through with. And I, for one, am glad that this was an option for me, and one, BTW, that my PM Dr. first suggested, not me.

So, this thread has been going on for 2 years. Jonathan, how are things going for you?

Personally, I blew out L-3 thru S-1 in the early 80's and after getting a cushy desk job on the late 90's, my muscle mass deteriorated, thus giving me all the problems that everyone here has experienced. I had the surgery in 2003 to remove the discs (what was left of them) and to prop me up with cadaver bones, titanium rods and a fist full of screws. All went well until 18 months ago (give or take) when all that pain came back. I am on Oxycontin, Oxycodone, Valium, and Neurontin. I hate each and every one of these meds. In April of this year, I had the implant, it is a BOSTON SCIENTIFIC unit with the rechargeable battery. I recharge about once a week.
First, the trial was pretty much, just okay, I really wasn't impressed, but my PM really explained the differences between what the trial unit would do as opposed to what the full implant could do. (note COULD DO).
I had the implant, and it was not the most pleasant experience I have ever been through, but once they have started, you may as well keep going. I had nightmares for two weeks after.
Now, 3 months later, and I have learned to really use the machine. I have been in touch with the rep from Boston Scientific, and we've made some adjustments, but overall, not so bad. I had a really hard time using it at night, I just could not get to sleep with it, so, I would just turn it off. Easy as that. Now it's on 24/7, except when I recharge.
I read someone had it implanted, and the next day, wanted it out.. if you had this implanted and didn't know it would take months to get used to it, your PM is a quack, or you did not listen.
The electrodes have to fuse to the nerve with scar tissue. This can take up to 6 months, or even more. Still I can beef up the stimulation just by shifting my weight a bit on my hips, or twisting just a little.
The Boston Scientific model I have has 4 different settings, all that can be totally customized. I have a setting for the left hip, one for the right hip, one for walking and the forth is for lower back. My pain has a tendency to shift from time to time.
My charger goes into a belt that holds it over the control portion, implanted in my left buttock. I can recharge sitting, standing, walking or even in bed, I have fallen asleep with it on a couple of times.
I'm not thrilled with the battery implant, as I have lost about 30 lbs, and in my own mind, I think people can now see this box poking out of my buttock. Of course, they can't but, if I can feel it, people can see it. The actual issue is, after I charge, or if I play around with it, the area feels bruised.
This unit or the procedure itself, is not for everyone, but I'll tell you this, if your PM suggests it, get a second opinion, or at least talk about it with your GP. Do your research.
With all the R&D being done on pain and devices like these, they are getting better all the time.
There are choices now, even when it comes to the implants you get.
Personally I can't see having a battery that did not recharge, for me, I think that would have been a deal breaker, but even the rechargeable batteries have to be replaced from time to time. They tell me the life expectancy of my battery unit is 5 years. I hope they are right.

http://www.bostonscientific.com/procedure/ProcedureLanding.bsci/,,/navRelId/1000.1002/method/Procedure/id/10001261/seo.serve

Another thing to consider........after having the spinal stimulator implanted your body has to heal. Meaning that as the spot where the stimulator was implanted has to heal scar tissue and the healing process will change as this happens. I too have had the temporary and the perminent versions of the Boston Scientific rechargeable type. It helped my leg pain but I still have tremendous back pain and am still on the same oral doses of medication that I was on before the stimulator. All I can say is avoid surgery and exhaust all options first before allowing to cut! I had back problems from the time I was 18 and then in 2004 was involved in a motor vehicle crash in which I herniated S1/ L5, L5/L4 and L4/L3. Pain is hard to treat due to the fact that different people perceive pain in different ways and is all subjective to what your Doctor thinks. You have to be open and honest with how you feel and cannot let others tell you how you feel!

Well said. " Pain is hard to treat due to the fact that different people perceive pain in different ways"

This is why they have given the pain chart. No 2 people will have the same pain level for the same issue.

The SCS is just another treatment plan, it is NOT a cure, however for some, it can make the difference between being able to live a life, or not.

I do disagree with it's what your doctor thinks, it's not. It's 100% about you, the patient. This is YOUR PAIN, As you said, you can't let others tell you how you feel, not even your doctor.

My situation is much like yours except I have the additional huge issue of having fibromyalgia. I have serious back (DDD) and leg pain along with FM. I am on the same meds as you. My pain doc wants me to have a SCS implanted to help with the leg pain, which the meds I'm on don't really help.The last of many procedures I had on my back took 7 months for the painful muscle spasms to go away in the muscles where the needles were inserted. I am very concerned that I will have a big problem with healing from a SCS implant procedure (because of the fibromyalgia), especially in the area where the battery is inserted. Has anyone here with FM had a SCS implanted? If you have, please tell me of your experience, if so. I know everyone has different experiences with this procedure, but I'm looking for as much imput as possible. I have posted this in the FM discussion area also but I think I'll get more answers here. Thanks.

Hi Now This,
I do like mine a lot, but I have to warn you of one thing I did recently...I was using it because the meds weren't enough, and it felt so good I relaxed and fell asleep. THEN my dog wakes me up wanting to go out. He's huge, so I want him to go out rather than cleaning up after a pony in the house. I got up, half asleep, forgrtting I had the Muscle Stimulator on, and headed to my bedroom door, not far. Just as I got to the doot the unit fell off mt bed, BAM! (wood floors) I jumped and turned around to see what that noise was, at the same time feeling the tug of the electrodes, but I fell out my bedroom door, down 2 steps, and wound up in some position I stil don't know how I got in. It took quite a while Make a sign or whatever you gotta do, but don't do that. That was the only unpleasant thing so far, and that was my fault. I've done all the junk above, yired of endless pills, procedures, I feel for you. Anyway, I hope you get one, get the big one with 8 electrodes. It covers everywhere (close as you can get) it hurts. I've never regretted getting mine, just regretted not unplugging when I was awoken. ; / Good luck, feel good, or pretend well enough to convince you a little, lol! Gimp

I have had RSD( Reflex sympathetic dystrophy) for 11 yrs now. It's in both of my feet and legs. What a constant battle this ordeal has been for me!!! When I first developed the RSD in my right foot and leg from a work injury, torn ligaments and a chipped bone in my foot the RSD set in 4 weeks later. It took several months for the orthopedic surgeon to get me in to conform the case. I had 23 lumbar injections, that didn't help. Then came the SCS, I wish I could go back in time and NEVER have that done!!! I ended up having 4 revisions, then the SCS completely removed. When it was on, it would "literally" shock me like I had stuck my finger in a plug in. Go into walmart, the sparks would fly from the cart because of the static electricity in my body. I was in more pain then I was before I started. I live on pain medications, I'm not able to sit or stand very long without my legs and feet blowing up like an elephants legs. I'm either on the couch with my legs propped up on pillows or in bed the same way. Without any pain meds, I hurt from my waist down. Between the scar tissue, rheumatoid arthritis and fibromyalgia It gets to be unbearable. I too have considered suicide as well multiple times, but I do have a son and I cant do that to him. I take the same pain meds you do but higher mg. I've developed so many allergies to medications now I have to be very careful what a dr. prescribes for me. I hope you think alot about this before you do it, I try to tell my story to others before they have to suffer more afterwards then before. Good Luck to you

"Ndanav," if you have newer and more comprehensive spinal intervention research, please proffer it for us. If not, mine stands as the most valued recent large-scale, double blind, algorithmic-based control group research. But don't take my word for it. Check with PainTopics.com.

I never said that SCS patients will develop MRSA and be felled by it. Mortality is very low. But morbidity is not. All surgery entails risk - even surgery to implant a mechanical device. My wife almost died from having surgical screws removed from her ankle. Medical facilities are breeding grounds for bacteria and viruses. The patient considering surgical implantation of an SCS should take it into consideration.

My comment about the SCS and IT pump being last-resort options came right from physicians, the PDR, pharmacologists and from medical research. I did not make it up. However, two spine surgeons, a neurologist and an orthopedic surgeon said it to me virtually word-for-word. Again, this comes from physicians, not me.

Why on Earth would you suggest that I was asking people here to experiment on their own with all types of pain medications? I am not disposed to recommend in a public forum that people break the law or do something dangerous (such as having surgery to implant a medical device before trying non-invasive options first). My internist and I experimented with various combinations of different pain medications and off-label drugs over a ten-year period. In the end, we discovered the best combination for my unique body chemistry. Once more, Ndanav, this recommendation comes from physicians at two pain management programs and my internist. I did not make it up. A little research on your part should confirm this. If, after trying all drug combinations AND all non-invasive treatments, the patient continues to have unsatisfactory pain management, the SCS and IT pump remain viable alternatives. And while my post-graduate work was not in medicine, I have and continue to conduct significant spinal reseach.

I have posted a list of alternative treatments for chronic pain on WebMD many times. I take it you haven't seen it yet. So, for your benefit, here it is again:

spinal decompression, a corset, brace, TENS, traction, acupuncture, biofeedback, physical therapy, kinesiotherapy, injection of steroids and anesthetics, non-steroidal anti-inflammatories, spinal decompression, cortisone, rhyzotomy (radio frequency denervation), spinal cord stimulator, intrathecal infusion pump, off-label medications (anti-depressants, anti-convulsants), combination of long-acting pain medication with breakthrough meds, counseling, hypnosis and meditation. I can reduce my pain by about 20% with biofeedback alone.

Just one medication added 9 wonderful years to my university career. It still helps a great deal. I am not asking anyone here to try what has worked for me. But after 40 years of chronic pain, four surgeries, two pain clinics and then every reasonable remedy, I might have something valid to offer. The rate of addiction among chronic pain patients appears to be exceedingly low (lower than 3%). Again, I have research to back it up here: http://updates.pain-topics.org/2011/01/study-finds-low-risk-of-rx-opioid-use.html and here http://www.ncbi.nlm.nih.gov/pubmed/20091598?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1

To simply dive in with the SCS or IT pump without first trying non-invasive options seems irresponsible and potentially dangerous. This information comes from knowledgeable physicians (including my father, who was a neurologist and psychiatrist) as well as from comprehensive research.

Thank you Beth for all the info you have written. I'm going through the trial right now. I so relate to the way you view yourself and it's nice to know I'm not alone in these struggles and there is hope. God Bless!