Spinal cord stimulation

SCS is the electrical stimulation over the dorsal aspect of the spinal cord for the relief of pain. It is an implanted device akin to cardiac pacemaker/defibrillator.

It is an established treatment within the UK and is funded by the NHS for neuropathic pain. It can also be used to treat ischaemic (refractory angina and chronic critical limb ischaemia) and visceral pain (chronic abdominal pain) although not funded by NHS.

 

The patient process

Check-up & Diagnosis

Patients who are considered for SCS have generally had chronic pain for more than a year. Chronic pain has a physical and emotional impact, so generally the sufferer has complex needs that need to be evaluated. First the correct medical diagnosis and pain mechanism is understood, and then the psychological impact is evaluated.

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Research and development
I have been at the centre of UK and International SCS research, both in establishing SCS as a treatment available to NHS patients and seminal research informing the development of sub-perception SCS.

Read more about my research

     

Looking for medical help?
If you suffer from severe chronic
pain, fill out the quick online
questionnaire to discover what
treatment could work best
for you.

Take me to the questionnaire

Spinal Cord Stimulation

SCS is the electrical stimulation over the dorsal aspect of the spinal cord for the relief of pain. It is an implanted device akin to cardiac pacemaker/defibrillator.

It is an established treatment within the UK and is funded by the NHS for neuropathic pain. It can also be used to treat ischaemic (refractory angina and chronic critical limb ischaemia) and visceral pain (chronic abdominal pain) although not funded by NHS.

 

The patient process

Treatment plan

The idea is to not only determine if they are good candidates but also to support them through the process of health improvement. This might include learning better pain coping styles, reducing dependency on habit forming medication and learning to gradually restore physical function.

Take me to the next process

Research and development
I have been at the centre of UK and International SCS research, both in establishing SCS as a treatment available to NHS patients and seminal research informing the development of sub-perception SCS.

Read more about my research

     

Looking for medical help?
If you suffer from severe chronic
pain, fill out the quick online
questionnaire to discover what
treatment could work best
for you.

Take me to the questionnaire

Spinal Cord Stimulation

SCS is the electrical stimulation over the dorsal aspect of the spinal cord for the relief of pain. It is an implanted device akin to cardiac pacemaker/defibrillator.

It is an established treatment within the UK and is funded by the NHS for neuropathic pain. It can also be used to treat ischaemic (refractory angina and chronic critical limb ischaemia) and visceral pain (chronic abdominal pain) although not funded by NHS.

 

The patient process

Home trial

It has been usual to offer a home trial of the SCS with implanted leads and external pulse generator device. If successful the full implant can be completed. My recent service reviews and clinical research has questioned the value of an extended trial period since more than 90% of selected patients have the full implant anyway with very few late explantation for therapy failure. Until published and agreed by NICE it is unlikely that the trial period will be omitted. Although as a self pay patient this can be done.

Take me to the next process

Research and development
I have been at the centre of UK and International SCS research, both in establishing SCS as a treatment available to NHS patients and seminal research informing the development of sub-perception SCS.

Read more about my research

     

Looking for medical help?
If you suffer from severe chronic
pain, fill out the quick online
questionnaire to discover what
treatment could work best
for you.

Take me to the questionnaire

Spinal Cord Stimulation

SCS is the electrical stimulation over the dorsal aspect of the spinal cord for the relief of pain. It is an implanted device akin to cardiac pacemaker/defibrillator.

It is an established treatment within the UK and is funded by the NHS for neuropathic pain. It can also be used to treat ischaemic (refractory angina and chronic critical limb ischaemia) and visceral pain (chronic abdominal pain) although not funded by NHS.

 

The patient process

Implant procedure

SCS is a rapidly advancing field of medicine. Technological advances mean that most implanted devices are rechargeable and can support large numbers of contacts (up to 32) so shaping and targeting the electrical field more precisely for parasthesia based SCS. Sub-perception SCS involves applying carefully managed charge density to the dorsal horns without activating conscious dorsal column pathways. Patients like to have access to both types of SCS with outcomes better with one or the other or with both simultaneously.

Research and development
I have been at the centre of UK and International SCS research, both in establishing SCS as a treatment available to NHS patients and seminal research informing the development of sub-perception SCS.

Read more about my research

     

Looking for medical help?
If you suffer from severe chronic
pain, fill out the quick online
questionnaire to discover what
treatment could work best
for you.

Take me to the questionnaire

Multifidus nerve stimulation - MFS

The multifidus muscle is the important ‘core muscle’ of the low back (The mainstay). Primary and secondary muscle motor/sensory dysfunction of this muscle group is responsible for most low back pain.

MFS is the activation of the multifidus muscle by stimulating the nerve end plate as it enters the anterior surface of the muscle. Direct nerve stimulation ensures FULL but gentle tonic contraction of the muscle. Over time this activation restores normal motor/sensory control overcoming the dysfunction, rehabilitating the core muscles and reducing or eliminating back pain.

 

The patient process

Check-up & Diagnosis

Some patients’ lives are dogged by chronic/continuous or severe frequent recurrent episodes of low back pain. Many will get temporary benefit from physical therapy or even targeted injections. It is this group who appear to do well with MFS. The patient needs to accept using a lifelong implant; it is a restorative therapy that treats the underlying condition of chronic back pain.

Take me to the next process

Research and development
Much of the early research of this therapy has been done within the UK. I have been involved in the post marketing clinical follow-up study which will follow several patients for 5 years.

Read more about my research

   

Multifidus nerve stimulation - MFS

The multifidus muscle is the important ‘core muscle’ of the low back (The mainstay). Primary and secondary muscle motor/sensory dysfunction of this muscle group is responsible for most low back pain.

MFS is the activation of the multifidus muscle by stimulating the nerve end plate as it enters the anterior surface of the muscle. Direct nerve stimulation ensures FULL but gentle tonic contraction of the muscle. Over time this activation restores normal motor/sensory control overcoming the dysfunction, rehabilitating the core muscles and reducing or eliminating back pain.

 

The patient process

Implant procedure

Under local anaesthetia and deep sedation, two leads of electrode contacts are injected at the 3rd lumbar transverse process so as to stimulate the nerve to multifidus. These are connected to an implantable pulse generator. These are tested and then implanted under the skin and fat layer of the low back. Once healed the device is programmed so that when activated by the patient it can deliver a sequence of gentle contractions for half an hour morning and evening.

Research and development
Much of the early research of this therapy has been done within the UK. I have been involved in the post marketing clinical follow-up study which will follow several patients for 5 years.

Read more about my research