As the spinal cord is part of the central nervous system, its proper function is critical to an individual’s quality of life. The central nervous system controls the body’s sensory information (pressure, touch, temperature, pain) which travels in established pathways into the spinal cord and onto the brain where the signals are interpreted into the different experiences. When the spinal cord is damaged, it can lead to a variety of symptoms including: loss of movement, difficulty breathing, loss of bowel/bladder control, and many others. Continue reading to learn when a spinal cord stimulator may be necessary to correct a patient’s condition and allow them to live pain-free.

What is a Spinal Cord Stimulator?

A spinal cord stimulator (SCS) is a small surgically implanted device which transmits electrical pulses that disrupt the transmission of pain signals reducing or eliminating pain from almost any part of the body. It is believed that electric pulses prevent pain signals from being received from the brain. The device itself consists of thin wires (the electrodes) and a small, pacemaker-like battery(the generator). Once implanted, the individual can control the electrical signals from an external wireless programmer to adjust the stimulation, switch between programs, and turn it on/off to alleviate the pain.

What Is a Spinal Cord Stimulator?

What is Spinal Cord Stimulation Used For?

Spinal cord stimulators can be an option for patients with a myriad of conditions, including but not limited to:

  • Spinal stenosis 
  • Neuropathy
  • Pinched nerves
  • Post-knee replacement pain
  • Post-hip replacement pain
  • Complex regional pain syndrome (CRPS)
  • Failed back surgery syndrome
  • Shingles pain
  • Peripheral vascular disease

Spinal Cord Stimulator Surgery

If you’re a candidate for a spinal cord stimulator, it’s important to understand that there are 2 separate procedures you must undergo; the trial and the implantation. 

Spinal Cord Stimulator Trial

  • Before the device is permanently placed, the GSMC team will implant a temporary device for three to ten days  to see if it can help to alleviate the long-term pain. During the implantation process, the electrode is placed through a needle into the spine and the generator is taped to the back so that no incisions are made. During the trial period, the patient will be able to test the device for improved pain relief and function. If the patient notes significant improvement, they may elect to proceed with the implanted device. the.

Spinal Cord Stimulator Implantation

  • After the trial is complete and if the patient notes significant improvement in pain relief and function, we will move forward with the second procedure which is to implant the device underneath the skin. During the procedure, the trial electrodes are replaced with sterile electrodes and are carefully placed along the spinal cord. The generator is then placed underneath the skin located above  the buttocks.  

Both procedures are done under light sedation and patient’s are able to return home the same day.

Types of Spinal Cord Stimulators

When it comes to types of spinal cord stimulators, the GSMC team recommends conventional and rechargeable generators to their patients. The main difference being that with a rechargeable stimulator, you can recharge it without another surgery versus a conventional stimulator requiring another surgery. Rechargeable systems tend to last longer, but must be charged 1-2 times a week (noninvasive) while conventional stimulators have no ongoing upkeep, but its battery needs to be replaced sooner.

There are a number of different manufacturers of the device, each having proprietary software to deliver the energy in unique ways. Some stimulators give patients a tingling feeling while others feel nothing other than pain relief. The majority of the systems that our team uses are also MRI compatible as well.

Spinal Cord Stimulator Recovery

Once the implantation is complete, patients are discharged the same day, typically within an hour after their procedure has finished.  In the days following, it is common to feel pain around the incision sites, with the full healing taking between 2-4 weeks. During that time, we recommend taking it easy and avoiding any activities that may aggravate the areas. However, often 1 week after the surgery patients are able to return to work and go about their normal activities.

Interested in learning if you’re a candidate for a spinal cord stimulator? Call to set up your consultation today: 1-888-376-2661


January 9, 2019 Spinal Cord Stimulator0

Do you often experience back pain at the end of the day? If so, you’re not alone. Roughly 80 percent of Americans will have back pain at some point in their lives.

But what do you do when your back pain is constant? Chronic back pain is more than just an annoyance. It can make it harder to do everyday tasks and may even prevent you from working.

If you’ve tried medication, back braces, trigger point injections, or any of the other numerous treatment options and are still feeling pain, it may be time to try spinal cord stimulation.

Do you want to learn more about this treatment for chronic back pain and all of the advantages it offers? Then keep reading!

What Is Spinal Cord Stimulation?

Wondering what exactly spinal cord stimulation is?

Well, it’s a type of surgery where a small battery-powered device is implanted near your spine. It then delivers mild electric currents to your spinal cord to block pain signals before they reach your brain.

You can control the electric currents with an external remote control. You can also turn the device on and off if you wish.

Now that you have a basic idea of what spinal cord stimulation is, let’s talk about why it may be the best option for you. We’ve listed the primary advantages of this treatment below.

1. It’s Adjustable

No two patients are alike. So it makes sense that the perfect solution to your chronic pain would be customized to you and your pain levels throughout the day.

Spinal cord stimulation does just that. You can adjust the level of electric currents from day to day or throughout the day as needed. If the pain gets worse, feel free to increase the electric currents to give yourself relief.

2. It’s Reversible

Of course, not every treatment works for every person. You may find that spinal cord stimulation isn’t for you.

You can have peace of mind knowing that this procedure is reversible. A surgeon can remove the implant and other accompanying equipment, and you won’t be left with any long-lasting side effects.

3. You Go through a Trial Run

Are you still a little worried that this treatment won’t work for you? Well, you’ll get a chance to experience a taste of spinal cord stimulation before undergoing surgery.

That’s right – it’s become commonplace to undergo a trial period first. How many other procedures can say that?

During this trial period, a temporary lead will be placed over specific nerves. You’ll wear an external generator on a belt that will let you see how effective this treatment will be.

If it turns out it’s not for you, you can walk away and research other options with no harm done.

4. You Won’t Need Prescription Drugs

Prescription drugs are a common treatment plan for those with chronic pain. However, there are quite a few downfalls.

Depending on your insurance, you may be paying a large sum out-of-pocket to get your prescriptions. This can cause a huge financial strain since you’ll need to keep paying for them month after month.

Additionally, taking prescription painkillers over a long period of time can result in addiction and drug abuse. In fact, roughly two million Americans have a substance abuse problem that stems from prescription painkillers.

Spinal cord stimulation can help reduce the painkillers you take and may even allow you to stop using them completely. Not only will this help you save money in the long run, but it’ll decrease your risk of addiction. 

5. Almost No Side Effects

Does your current medication make you feel drowsy or nauseous? Unfortunately, both prescription and over-the-counter medications typically come with a long list of side effects.

Spinal cord simulation works by blocking pain signals in one specific area. This means you won’t have to worry about any side effects that affect other parts of your body.

In fact, there are very few side effects to this option, and many people don’t experience any at all. 

6. Fast Recovery Time

The possibility of getting surgery is always a scary thought. You may also be worried about the long recovery time that could keep you out of work.

However, this isn’t a problem with spinal cord stimulation. You’ll experience mild discomfort for a few days after surgery, but that’s it. You won’t have to worry about taking weeks or months off from work to recover.

7. It’s Convenient

Alright, so getting surgery is never really convenient. But compared to other treatment options, spinal cord stimulation is, in fact, convenient.

You won’t need to worry about hitting the pharmacy every month for prescription refills or seeing your doctor every few weeks. You also won’t have to worry about long recovery periods that are needed for other types of spinal surgery.

Instead, you’ll go through your trial run, have the surgery, and be back to work in no time. You can continue this treatment plan for years without the need for regular doctor appointments.

Say Goodbye to Chronic Back Pain for Good

Don’t let chronic back pain stop you from living your best life. If you feel like you’ve exhausted all your other options, it may be time to give spinal cord stimulation a try.

Request an appointment with us today to discuss spinal cord stimulation or other treatment options. We can help you manage pain in many areas of the body, from your head to your feet.


January 2, 2019 Spinal Cord Stimulator0

If you suffer from pain in your back, you’re not alone. Unresolved back pain plagues millions of people across the United States. The CDC reported that in 2016 nearly 50 million U.S. adults suffered from chronic back pain.

One common way physicians figure out the cause of back pain is to perform a discogram procedure. If your doctor recommended a discogram test, you probably have a lot of questions.

Read on to learn all about the discogram procedure and how it works to reveal the source of your chronic back pain.

What is a Discogram Procedure?

A discogram test is an invasive diagnostic procedure that examines the intervertebral discs of the spine using x-rays. These spinal discs act as spongy cushions between the vertebrae (the bones) of the spine. Issues with these discs often cause chronic back pain. 

Regular x-rays only provide a picture of the bones and not what’s going on around or inside. Another type of procedure, a myelogram, only offers a view of the spinal canal.

A discogram works well to precisely locate the damaged discs to determine if they are the cause of your back pain. But how can they see the discs if they still use an x-ray?

How a Discogram Procedure Works

A physician uses an x-ray monitor known as a fluoroscope to see into the spine. The arc-shaped machine is also known as a C-arm. It extends from one side of the body to the other and generates x-rays on one side and an image of them on the other side. 

Using the fluoroscope machine to guide them, the physician inserts a hollow needle through the skin straight into the center part of the disc space. Then the physician injects a special dye called a contrast dye into the injured disc(s).

The dye floods the disc and makes it visible through the fluoroscope monitor by staining it white. The dye works in two ways.

First, it reveals what the disc looks like and highlights any visible injuries. Second, it tries recreating the pain so your physician can determine if that particular disc is the source.

If you do not feel the same kind of pain, it’s likely your pain originates from another place.

How to Prepare for a Discogram Test

Your doctor should provide instructions on how to prepare for the discogram test when scheduling it. Generally, you cannot eat any solid foods after 12:00 am the night before your procedure.

You will need someone to drop you off and pick you up, so be sure to make arrangements.

Dress in warm, comfortable clothes like sweats or other exercise clothing. Be sure you leave all valuables and jewelry at home.

Also, be sure to inform your doctor of any medications you take since you may need to stop taking them for up to a week before the surgery.

What to Expect Before, During, and After a Discogram Procedure

Expect to be at the hospital or clinic for around 3 hours. The test itself should only take 30-60 minutes depending on how many discs they test. However, there are other things you will need to do while there.

Before Your Test

Just before the procedure, you’ll need to change into a hospital gown. The nurse will come in to put an IV (intravenous) line into your arm.

Then the interventional pain physician or pain specialist willexplain the procedure to you again, answer any last questions, and ask you to sign the consent forms. 

During Your Test 

You enter the procedure room and lie down on your side or abdomen. The person performing the discogram test will clean your skin and, possibly, inject some numbing medication into the predetermined procedure area on your back.

This will minimize the slight burning sensation caused by inserting the needle.

Using the fluoroscope, the doctor performs the procedure as described above. They then watch what happens to the dye through the machine. 

Discogram Results

If the dye remains in the center of the disc, the discogram results are normal. If the dye moves through the disc from the center, it shows the disc has suffered some wear and tear and is abnormal.

An abnormal discogram test result may or may not indicate the disc is the source of your back pain. If you felt pain during the procedure similar to the pain you want to have addressed, it’s likely that particular disc is causing your pain.

The radiologist will continually ask you to rate your pain throughout the procedure. 

After Your Test

You must stay in the procedure room for observation for another 30-60 minutes. You will need someone to drive you home after being released.

Expect some soreness around the injection site that lasts for several hours after the procedure. Putting an ice pack on for 20 minutes on and 20 minutes off can help as well as taking a pain reliever like ibuprofen (Advil/Motrin).

Are There Any Risks? 

There are very few risks associated with a discogram procedure. The biggest concern is whether or not you have an allergy to the contrast dye.

Tell your doctor before the test if you ever experienced an allergic reaction to xylocaine or any other medication.

There’s a slight chance of infection in the spine, but less than 1/10 of 1%. The majority of discogram procedures go as intended with no issue.

Just be sure to alert your doctor if you notice any swelling, bleeding, or pain more than a couple days after the procedure.

Get Relief from Chronic Pain in New Jersey

For chronic pain suffers, it may seem like there’s no light at the end of the tunnel. The longer you suffer in silence, the less chance you have to find a solution.

Speak with a pain specialist doctor about your chronic pain to see if they can diagnose your back pain with a discogram procedure.

Not familiar with any pain specialist doctors near you? If you live in New Jersey, the Pain Management Institute at the Garden State Medical Center is your best option.

Their pain experts perform many invasive and non-invasive procedures to help their patients feel better fast.

Contact Garden State Medical Center today to schedule a consultation. You can also find answers for your other chronic pain questions, like when to see a doctor for joint pain, on their easy-to-understand pain management blog.


August 13, 2018 Spinal Cord Stimulator0

Did you know that opioid abuse in chronic pain patients is around 25 %?

There are options out there to aid with chronic back pain. In this article, we are going to discuss why a spinal cord stimulator might be the right choice for you. We will discuss how it can help with chronic back pain.

Are you interested in learning more about this? Keep reading to find out more!

Spinal Cord Stimulators for Chronic Pain

Patients experiencing chronic pain conditions without relief may be interested in Spinal Cord Stimulation. It can be a long-term and successful solution that will increase mobility and reduce pain, allowing you to return to an active lifestyle.

Spinal Cord Stimulation can treat:

  • Chronic Neck and Back Pain

  • Nerve Pain from many sources including shingles, peripheral neuropathy

  • Postlaminectomy syndrome or Fail Back Surgery Syndrome

  • Refractory Angina

  • Complex regional pain syndrome

How Spinal Cord Stimulation Works

Spinal Cord Stimulators deliver electrical pulses to the spinal cord. The electrical impulses are mild, and they help to mask the pain signals that are being sent to the brain. By hiding your pain with electricity, we often are able to substantially reduce and eliminate pain.

Spinal Cord Stimulation Advantages

  • Medication free/has shown to help get patients off medication

  • Reversible – can be taken out if needed

  • Minimally invasive – not major surgery!

  • Evidence to support improvement in function and quality of life

Looking at Getting a Spinal Cord Stimulator?

This may not be your physician’s first suggestion when discussing ways to treat your chronic pain. However, if you have experienced the pain for a long time and have tried other options such as physical therapy/chiropractics, injections, surgeries, and medications which have failed to offer you relief, spinal cord stimulation maybe an appropriate treatment option.

The best part about spinal cord stimulation is that there is an ability to “test drive” the device before deciding it is right for you. During this temporary trial, an external simulator is applied so you can experience the sensations and the effectiveness of the treatment before moving forward. If the device fails to provide you adequate relief, the test drive is ended. If the device works well, it is a minor outpatient surgery to have the device implanted.

What to Know About Stimulation

The spinal cord stimulator isn’t going to eliminate the source of the pain. Like we discussed before, it will help interfere with the signals being sent to the brain. The amount of pain relief will vary per person. That is the purpose of using a “test drive” prior to implanting the device which allows an individual patient to determine if spinal cord stimulation is right for him/her. The ultimate goal for this is to reduce 50-70 % of the pain that the patient is experiencing however pain relief is just one aspect of the benefits to spinal cord stimulation. Other metrics used to determine success include functional ability and medication use. Our goal is to help patients be able to do more with less medications.

Spinal Cord Stimulator Device Systems

There are several companies that make spinal cord stimulation devices. The basic unit has three main parts:

  • A battery that generates the electrical pulses.

  • Wires that carry and deliver electrical pulsations to the spinal cord.

  • A remote control you can hold that turns the device off and on and also adjusts settings.

There are two battery types – rechargable and non-rechargable. There are pros and cons of both. Rechargable batteries tend to have a longer life span (does not need to be surgically replaced as often) however there is a charge burden (often 30-45 minutes every other day). Non re-chargable batteries often mean less day to day hassle however the battery needs to be surgical replaced more often.

Your physician at Garden State Medical Center can go over the differences and help determine what is the right system for your individual needs.

What Are the Results for Spinal Cord Stimulators?

We know that stimulation does not cure the condition causing the pain but instead helps the patient manage it.

Spinal cord stimulators are considered successful if the pain is reduced by at least half.

Studies of spinal cord stimulation reveal strong to excellent pain reduction in 50-80 % patients suffering from chronic pain.

One research shows that 24 % of patients are even able to go back to their jobs or complete housework without the addition of pain medication.

If a patient does decide that they no longer want to continue the therapy, it is reversible. The generator and electrode wires can be removed completely.

Are There Any Risks?

Spinal Cord stimulation is not perfect. There are risks with everything in life and this is no different. The basic risk of any invasive treatment is bleeding, infection, damage to nearby structures. In addition, spinal cord stimulation carries some specific risks:

  • Changes in the stimulation could occur due to cellular changes in tissue surrounding the electrodes, changes in electrode position, or loose electrical connections.

  • Lead migrating – the wires can move

  • Lead fracture – the wire can break

  • Habituation – getting used to the stimulation to the point it is no longer helping the pain.

Many of these issues can be improved by a simple re-programming which is an adjustment to your device from the company representative. If that fails to improve the problem, you may need to have a revision surgery to fix the device.

Learn More

In this article, we discussed what a spinal cord stimulator is and how it can help you.

Are you interested in learning more about your options? We can help you.

Remember that you don’t have to live with chronic pain. There are options out there that don’t include pain medication


Peripheral Artery Disease (PAD) is a circulatory problem that occurs when you have reduced blood flow to your limbs. One of the primary symptoms is pain when walking.

According to Mayo Clinic, you can treat PAD by improving your lifestyle, i.e., quitting smoking, exercising, and eating healthy.

When that isn’t enough, a Spinal Cord Stimulator (SCS ) is one alternative PAD treatment that has proven to relieve pain.

What Is Peripheral Arterial Disease?

Peripheral arterial disease (PAD) occurs when the blood vessels outside of your heart begin to narrow. Atherosclerosis causes PAD. Plaque builds up along artery walls.

These arteries supply blood to the arms and legs. The blockage reduces or even stops blood flow, most often to the legs.

If the condition becomes severe, the blocked blood flow causes tissue death. It can lead to the amputation of a leg or foot.

Risk Factors

Smoking is the leading risk factor for PAD. Older age in another risk factor. Finally, other conditions that present risk for PAD are diabetes, high cholesterol, high blood pressure, heart disease, and stroke.

PAD increases your risk of stroke, heart attack, and transient ischemic attack.

PAD Symptoms

Many people who have PAD don’t experience any symptoms. Those who may experience numbness, pain, aches, or heaviness in the leg muscles. These happen when you walk to climb stairs.

Another symptom is weak or no pulses in your legs or feet. You may experience sores on your feet or toes. Wounds may take an extra-long time to heal or not at all.

You may have a pale or bluish color to your skin, and a lower temperature in one leg over the other. Your toenails may not grow well, and you may have decreased hair growth on your legs.

How Does a Spinal Cord Stimulator Provide PAD Treatment?

A spinal cord stimulator (SCS) is a medical device that sends a mild electric current to your spinal cord. A surgeon places it under your skin.

The current travels through a small wire from a pulse generator to the nerve fibers of your spinal cord. When you turn the SCS on, it SCS stimulates the nerves in the area where you feel your pain.

This stimulation provides PAD treatment by reducing the pain. The electrical pulses mask and modify the pain signal. It keeps the pain signals from reaching your brain. Sometimes the SCS replaces the pain with a tingling feeling.

The SCS PAD treatment can’t eliminate the source of the pain. Rather, it interferes with the signal traveling to the brain.

The result is pain relief. How much pain relief the person experience varies. Also, some find that tingling feeling to be unpleasant.

Trial Stimulation

For the reasons mentioned above, doctors perform a trial stimulation before they implant the device permanently. The goal for the patient is at least50%pain reduction using the device.

Yet, even a minimal amount of pain reduction can be significant. It could be enough to help you complete daily activities with less pain. It could also reduce the amount of pain medication you have to take.

Stimulation does not work for everyone, however. If it is unsuccessful, the surgeon can remove the trial leads without any lasting harm. Doing so will not damage the spinal cord or nerves.

SCS Components and Variations

Some SCS devices use a low-frequency current, which aims to replace the pain with a mild tingling feeling. This tingling is known as paresthesias.

Other SCS devices use burst or high-frequency pulses to mask the pain without the tingling feeling. Most devices have a paresthesia-free setting.

SCS devices all have three main parts. A pulse generator with a battery creates the electrical pulses. A lead wire with electrodes sends the electrical pulses to the spinal cord.

A hand-held remote control allows you to turn the device on and off. It also allows you to adjust the settings.

If you have a system with a non-rechargeable battery, you will need to have it surgically replaced every few years, depending on how much you use it.

Rechargeable battery systems last up to 10 years or longer, but you have to charge them every day.

Development History and Studies of SCS

Researchers initially developed SCS devices in the 1960s. Since then, doctors have been prescribing SCS for peripheral vascular disease treatment as well as peripheral artery disease treatment.

Cook & Associates Study 1976

In Europe, PAD was the primary indication for SCS. In 1976, Cook & Associates used SCS PAD treatment to heal chronic leg ulcers. In addition to relieving pain, this and other studies have shown that SCS can improve patients with PAD.

Patients who received the SCS devices showed improvements in several areas. They experienced greater exercise tolerance and limb salvage along with a reduction in their pain.

Studies Using SCS to treat Peripheral Vascular Disease (PVD)

In the 1980s through the1990s, researchers in Europe used SCS PAD treatment as an alternative treatment measure for Peripheral Vascular Disease (PVD) as well as for PAD.

PVD causes atherosclerosis of the veins of the lower extremities. It initially presents as pain with walking that is relieved by rest. If untreated, PVD leads to neuropathy and muscle deterioration. It can eventually lead to limb loss.

SCS PAD treatment was and is promising for pain associated with PAD and the related condition of PVD. During peripheral vascular disease treatment, patients experienced less pain.

They also increased circulation, enough to avoid losing a limb. The positive effects last for at least one year in 80% of patients. The effects continue for up to 5 years in 60% of patients.

SCS Improves Multiple Symptoms for Patients with PAD

In 1986, Broseta et al. conducted a study in Spain. It showed how SCS PAD treatment could improve more than pain symptoms in patients with PAD. All patients in this study had pain from PAD in the lower limbs.

During peripheral vascular disease treatment, patients experience relief from their pain as well as better blood flow and an improvement in trophic lesions.

After the trial stimulation, 37 patients received permanently implanted stimulators. After twenty-five month, 29 patients reported 75%-100% pain relief. Fifteen patients showed improvements in blood flow.

The overall conclusion was that SCS is a valid, alternative treatment for moderate PAD, especially when surgery on the arteries is not possible or recommended.

Is SCS PAD Treatment Right for You?

If you have PAD or PVD, then peripheral artery disease treatment or peripheral vascular disease treatment with an SCS device may provide some relief.

While studies show PAD treatment does not help every patient, it has statically provided relief to many.

If you are in the Garden State area, please contact us for an appointment today.

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