When is a Spinal Cord Stimulator Implant the Right Choice?


You may have seen reports in the news about spinal cord stimulator implants injuring some patients. These medical devices can certainly be appropriate for some long-term, chronic pain cases as a last-resort option. Yet, given the associated health risks, you may first want to consider other less invasive electrotherapy options for chronic pain treatment.

Not All Electrotherapy Devices are the Same

The first thing to know is that not all electrotherapy pain relief devices are the same. There are three primary types to consider:

  • Surface stimulation devices

  • Percutaneous devices

  • Surgically implanted devices

Implanted Devices Pose the Highest Degree of Risk

Spinal cord stimulators, also called “implantables,” are the most invasive form of electrotherapy because they involve surgically embedding a stimulator beneath the skin. (This is the type of device featured in major news stories.) During this procedure, the surgeon makes an incision to place the leads (medical wires) that deliver electrical stimulation into the epidural space of the spinal cord. A second incision is also made to create a pocket under the skin for the stimulator.

Because any surgery presents risk, of the electrotherapy options available on the market today, spinal cord stimulators present the greatest risk and highest cost – typically more than $50,000 for the initial surgery, plus ongoing maintenance.

Percutaneous is Less Invasive & Less Risky

Percutaneous stimulation is considered moderately invasive. It involves using electrode pads with tiny needles that penetrate through the skin to deliver electrical stimulation. The electrode pads are usually single-use to ensure safe hygiene, and a prescription is required.

The annual cost of percutaneous stimulation is far less than the cost of an implanted stimulator, and would be determined by the device used and the area treated. This treatment method can be appropriate for patients who suffer from complex pain symptoms that don’t respond to less invasive therapies, yet it still poses the risks of localized skin irritation and infection.  

Surface Stimulation Electrotherapy – Lowest Risk & Cost

Finally, surface stimulation is the most basic form of electrotherapy – where electrode pads are placed on the skin and electrical signals are transmitted through it to underlying tissue. Surface stimulation is non-invasive and the most cost-effective form of electrotherapy pain relief for the musculoskeletal system. From a hazard perspective, these devices also offer the lowest risk, as they don’t break the skin or require a surgical procedure.

There are many types of surface stimulation devices available today. Some are sold directly to patients over the counter. More full-featured and powerful devices are prescribed by physicians. Electrodes are typically useful for 30 days, making annual usage cost for a prescription-level device affordable. The RS-4i Plus Sequential Stimulator is an example of a surface stimulation electrotherapy device. It typically costs less than $2000 per year, inclusive of the device and a year’s supply of electrode pads.

Tips for Talking to Your Healthcare Provider

Many patients with chronic pain struggle to find a long-term solution. While opioids are a common line of defense, the danger of addiction is well-understood. Electrotherapy is a viable solution for pain relief that patients can self-manage in the privacy of their home.

If you suffer from chronic pain of the musculoskeletal system and wish to consult with your healthcare provider about the various electrotherapy device options, here are some questions to ask:

  1. What are the best options for relieving my pain at home without prescription medication?

  2. Which option is likely to address my pain while incurring the least amount of cost or risk?

  3. Before we implant a surface stimulator, please tell me about your experience with percutaneous and surface stimulation devices.

 Have you already spoken to your healthcare provider about electrotherapy devices? If so, feel free to add your questions or comments.

Related Resources

Blog: Deciding Which Electrotherapy Device will be Most Effective for You
Web: RS-4i® Plus Sequential Stimulator

This blog provides general information and discussion about medicine, health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately-licensed physician or other healthcare professional.

Donna PetersonComment