Living with chronic pain that refuses to respond to treatment can take a toll. You might’ve tried medications that dulled your thinking more than your pain, steroid injections, physical therapy or even surgery, but you’re still not where you want to be. As pain slows you down, the list of things you avoid grows longer, and you start wondering if you’ll ever feel like yourself again.
For patients who have reached that point, spinal cord stimulation offers a different path, one that works with your nervous system rather than simply masking symptoms. It’s FDA-approved, reversible during the trial period, and has helped thousands of patients across Orange County reduce chronic pain and get back to the activities they love most.
What Is Spinal Cord Stimulation?
Spinal cord stimulation (SCS) is a minimally invasive, implantable therapy that interrupts chronic pain signals before they reach the brain. A small device, similar in size and concept to a cardiac pacemaker, generates mild electrical pulses that travel through thin, insulated wires (leads) placed in the epidural space near the spinal cord. Rather than registering pain, the brain receives a different signal, often described as a faint tingling or, with newer sub-perception systems, nothing at all.
The therapy has been used safely for more than 50 years and is supported by a substantial body of clinical evidence. At Orange County Pain Clinics, SCS procedures are performed by fellowship-trained, board-certified physicians using real-time fluoroscopic guidance. Every implant plan is developed individually and tailored to the location and degree of your pain.
What Conditions Can Spinal Cord Stimulation Treat?
SCS is designed for chronic back pain that has not responded adequately to conservative treatments. It works best for pain that can be described as persistent, radiating or burning and tied to a documented underlying condition. Patients who have already tried medications, physical therapy or injections without lasting relief are typically the strongest candidates.
Conditions commonly treated with spinal cord stimulation include:
- Failed back surgery: Ongoing or new pain that develops after spinal surgery, often related to nerve irritation, scar tissue formation or incomplete decompression
- Complex regional pain syndrome (CRPS): A chronic nerve disorder typically affecting one limb, causing burning pain, temperature changes and heightened sensitivity
- Diabetic peripheral neuropathy: Nerve damage in the feet, legs or hands caused by long-term diabetes, producing numbness, tingling and persistent pain
- Degenerative disc disease: Chronic pain from disc breakdown that narrows the space around spinal nerves, particularly when other treatments have been exhausted
- Radiculopathy: Shooting, electrical pain that radiates from the spine into the arms or legs along a compressed or inflamed nerve root
- Sciatica: Radiating pain that travels from the lower back through the hip and down the leg, often caused by disc herniation or spinal stenosis
PAIN RELIEF A CLICK AWAY
Revolutionary New treatment, FDA approved Spinal stimulator implant “Nevro” for both nerve and back pain following failed spinal surgery
How Does Spinal Cord Stimulation Work?
Pain signals travel along nerve pathways from the site of injury or inflammation up through the spinal cord and into the brain. Conventional treatments, including medications and steroid injections, work downstream of that process, reducing inflammation or dulling the signal after it’s sent. SCS interrupts pain signals before they have a chance to reach the brain.
Once the leads are positioned in the epidural space, the pulse generator delivers low-level electrical current that modifies how pain information moves through the spinal cord. The result is that the brain either receives a different, less distressing sensation in place of pain, or, with newer waveform technologies like high-frequency or sub-perception stimulation, receives nothing notable at all. You control the level of stimulation through a handheld device, and settings can be adjusted throughout the day based on your activity level and comfort.
Is Spinal Cord Stimulation Right for Me?
SCS is not typically a first-line treatment. It’s considered after conservative and intermediate options have been tried and found insufficient. The goal of the trial period (with temporary leads placed which will be removed after 5 days) is to let you and your physician evaluate whether this therapy actually reduces your pain before any permanent commitment is made.
You may be a good candidate if you are experiencing:
- Chronic pain lasting three months or more
- Ongoing pain following back surgery that hasn’t resolved with additional treatment
- Neuropathic pain, burning sensations or CRPS that has not responded to medications or injections
- Radicular pain that persists despite epidural steroid injections or other interventional treatments
- Significant limitations in daily function related to your pain
- A desire to reduce reliance on opioids or other long-term pain medications
If this sounds like you, we encourage you to schedule a consultation with our team. We’ll evaluate your overall health and treatment history to determine if you’re a good candidate, and walk you through what to expect from your spinal cord stimulation trial experience.
What to Expect During the Trial and Implant
The Trial Period
The SCS trial procedure is performed on an outpatient basis and typically takes less than an hour. You’ll lie comfortably while the area around the spine is cleaned and numbed with a local anesthetic. Sedation is available if you’d prefer to be more relaxed during the procedure. Using fluoroscopic guidance, your physician will carefully advance one or two thin leads through a hollow needle into the epidural space, positioning them over the specific nerves that correspond to your area of pain.
Once the leads are in place, they’re connected to a small external stimulator worn on a belt or secured to your clothing. Before you leave, a clinical specialist will work with you to program the device and confirm that the stimulation is reaching the right areas. You’ll go home the same day with instructions on how to adjust settings and care for your temporary leads.
Over the next five to seven days, you’ll live as normally as possible. The point is to evaluate how the therapy performs during real daily activity. A few things to keep in mind during the trial:
- Bathing and showering are not permitted while the trial leads are in place; plan ahead
- Keeping a daily log of your pain levels and what you were doing helps your physician assess the trial accurately
- The leads are secured to the skin with dressings to minimize movement, but vigorous physical activity should be avoided
At the end of the trial, you’ll return to the clinic. If the leads are removed at that point, there is no lasting effect on the spinal cord or surrounding tissue. If the trial has reduced your pain by roughly 50% or more, and you’ve noticed meaningful improvement in your daily function, the next step is scheduling permanent implantation.
Permanent Implantation
The permanent implant procedure is also performed as an outpatient surgery under general anesthesia or conscious sedation, taking about one to two hours to complete. The temporary trial leads are replaced with permanent leads that are anchored in place to minimize movement. A small pulse generator is implanted beneath the skin, typically near the upper buttocks or flanks, and connected to the leads. You’ll be able to return home the same day, with aftercare instructions and activity restrictions to manage discomfort and ensure proper healing.
How Long Does Relief Last?
Relief varies depending on your underlying condition, how long you’ve had it, and individual differences in how the nervous system responds to spinal cord stimulation. Some patients experience substantial, sustained improvement from the initial programming; others require adjustments over the first few months as settings are optimized.
Rechargeable battery systems last eight to 10 years or longer with regular daily charging. Non-rechargeable systems require surgical replacement every two to five years. To ensure optimal, lasting pain relief, SCS at Orange County Pain Clinics is often integrated with physical therapy, chiropractic care and other modalities, allowing us to coordinate a plan that supports long-term pain management.
Meet the Specialists Behind Your Care
Spinal cord stimulation at Orange County Pain Clinics is performed by a team of physicians whose training and clinical focus place them among the most qualified SCS providers in Orange County. Dr. Afzaal Iqbal is double board-certified in anesthesiology and pain medicine. He completed his anesthesiology residency and interventional pain fellowship at the University of Rochester Medical Center, where he served as Chief Resident. Dr. Iqbal is one of the few pain physicians in Orange County with advanced expertise in spinal cord stimulation, dorsal root ganglion (DRG) stimulation and peripheral nerve stimulation.
Dr. Jason Kajbaf is double board-certified in physical medicine & rehabilitation and pain medicine, with a fellowship in interventional spine and pain medicine at UCLA. His background in rehabilitation shapes how the team thinks about recovery and function after procedures. Not just pain scores, but what patients can actually do with their days.
Because your care is guided by a team that spans diagnosis, intervention and recovery, treatment is never limited to one pathway. From conservative therapies to advanced image-guided and minimally invasive procedures, every plan is tailored to deliver meaningful pain relief, improved mobility and lasting results.
Frequently Asked Questions
What is a spinal cord stimulator?
A spinal cord stimulator is a small, implantable device that delivers mild electrical pulses to the epidural space near the spinal cord. Those pulses interrupt pain signals traveling toward the brain, reducing the perception of chronic pain. The system consists of a pulse generator implanted under the skin and thin lead wires that carry electrical current to the targeted nerves.
Is the SCS trial painful?
Most patients experience minimal discomfort during the trial procedure. Local anesthetic is used to numb the area, and sedation is available. Some patients feel mild pressure or a brief sensation as the leads are advanced, but the procedure is generally well tolerated.
How do I know if the trial was successful?
The clinical benchmark for a successful trial is typically 50% or greater pain reduction. That said, your physician will also be looking at whether you’re sleeping better, moving more freely or requiring less pain medication. You and your doctor will evaluate the results together at the end of the trial period before deciding whether to move forward with a permanent implant.
Can spinal cord stimulation help if I’ve already had back surgery?
Yes. Failed back surgery syndrome, which describes ongoing pain that persists or develops after spinal surgery, is one of the most common indications for SCS. Many patients who haven’t found lasting relief after one or more surgeries respond well to stimulation therapy.
Will a spinal cord stimulator allow me to have an MRI?
It depends on the device. Some modern SCS systems are MRI-compatible under specific conditions, while others are not. Your physician will review the device options with you during consultation, taking into account your medical history and any anticipated imaging needs.
Does insurance cover spinal cord stimulation?
SCS is covered by most major PPO insurance plans and Medicare when medical necessity criteria are met. Our team will work with you to verify your coverage prior to scheduling the trial procedure. Call our office, and we can help you understand your benefits before your first visit.