A spinal cord stimulator (SCS) is a small implanted device that delivers mild electrical pulses to the spinal cord to change how pain signals are processed before they are perceived as pain. It is an option for certain types of chronic nerve-related pain that have not responded well to other treatments. At Columbia Pain & Spine Institute in Gresham, every SCS candidate first completes a temporary trial, so you can experience the therapy before deciding on a permanent implant.
OVERVIEW
What a spinal cord stimulator is and how it works
A spinal cord stimulator is an implantable device — similar in concept to a cardiac pacemaker — that sends gentle electrical pulses to the spinal cord. These pulses modulate the pain signals traveling toward the brain, so chronic pain may be reduced or replaced by a more comfortable sensation. SCS does not cure the underlying source of pain; it is a neurostimulation therapy aimed at managing persistent nerve-related pain over the long term.
The system has two main parts: thin wires called leads, placed in the epidural space near the spinal cord, and a small pulse generator (battery) that powers the device. Our dual board-certified, fellowship-trained physicians use SCS as one part of a broader neurostimulation approach for carefully selected patients.
SCS is distinctive among our procedures because it follows a trial-then-implant pathway. You first undergo a temporary trial to see whether stimulation meaningfully reduces your pain before any permanent device is placed — a chance to test the therapy in everyday life before committing to an implant.
WEBINAR
Spinal cord stimulation, explained by Dr. Anthony
CONDITIONS
Conditions spinal cord stimulation may help treat
Spinal cord stimulation is supported by evidence for specific chronic pain conditions — particularly nerve-related (neuropathic) pain that has persisted despite prior surgery, medication, or other interventions. It is not a fit for every type of pain.
Commonly treats
YOUR VISIT
What to expect
Before
SCS is a two-stage process. After your evaluation suggests you may be a candidate, we schedule a temporary trial. Many patients are also asked to complete a psychological evaluation, which is a standard part of SCS candidacy. You will receive specific instructions about medications, including blood thinners, before your procedure.
During the trial
Using X-ray (fluoroscopic) image guidance for accurate, safe lead placement, the physician inserts one or more thin leads into the epidural space through a needle. During the trial, the leads connect to a generator worn outside the body. This trial placement is typically an outpatient procedure lasting roughly 30 to 60 minutes.
The trial period
You go home and use the device for about a week (typically 5 to 7 days) to gauge how much your pain improves with stimulation during normal daily activities. This is the deciding step: if the trial provides meaningful, worthwhile relief, you may proceed to a permanent implant. The temporary leads are removed easily in the office at the end of the trial.
Permanent implant & recovery
If the trial is successful, the permanent system — leads plus a small pulse generator placed under the skin — is implanted at our on-site Burnside Surgery Center in Gresham. Recovery guidance typically includes limiting bending, twisting, and lifting for several weeks while the leads settle. Your device is then programmed and adjusted to your comfort, with follow-up to fine-tune the settings.
FAQ
Common questions about spinal cord stimulation
Why is there a trial before the permanent implant?
The trial lets you experience spinal cord stimulation before committing to a permanent device. Because it tests whether stimulation actually reduces your specific pain during everyday activity, patients who get meaningful relief during the trial are the ones who typically move forward with implantation.
Will I feel the stimulation?
It depends on the device and how it is programmed. Some systems produce a gentle tingling sensation in the area of your pain, while newer technologies can provide relief without a noticeable sensation. Your physician will discuss the options and adjust the settings to what feels most comfortable for you.
Can the device be removed?
Yes. Unlike many spine procedures, an SCS system is designed to be reversible. The leads and generator can be turned off or surgically removed if the therapy is no longer helpful or if your needs change.
RELATED CARE
Related procedures & next steps
Spinal cord stimulation is one of several advanced options we offer for chronic nerve pain. Depending on your diagnosis, your physician may discuss related therapies.
Neurostimulation
Our broader neurostimulation program, including peripheral nerve stimulation for more localized pain. Learn more
Epidural & spinal injections
Image-guided injections that calm inflamed spinal nerves — often tried before SCS. Learn more
Radiofrequency ablation
Uses heat to quiet specific pain-carrying nerves for longer-lasting relief. Learn more