Spinal Cord Stimulation (SCS)- Frequently Asked Questions (FAQ)

Introduction

This leaflet answers common questions about spinal cord stimulation and what to expect before and after your implant.

What is a spinal cord stimulator?

A spinal cord stimulator (SCS) is a small, implanted device used to help manage certain types of long-term pain. It works by delivering gentle electrical signals to the spinal cord to reduce the sensation of pain.

An SCS system usually includes:

1. Implantable pulse generator (IPG)
   This is a small battery-powered device (about the size of a matchbox) that produces the electrical signals. It is usually placed under the skin in the upper buttock area, although other locations may be discussed with you before surgery.
2. Leads (thin insulated wires)
   One or two fine wires are positioned in the epidural space (an area near the spinal cord). These deliver small, carefully controlled electrical impulses.
3. Extension cable (if required)
   In some cases, an additional connecting lead links the wires to the battery device.

All of the above components are placed inside the body during your procedure.

1. Hand-held controller
   This allows you to switch the stimulator on or off and adjust the settings within safe limits. It is similar in size to a mobile phone.
2. Charging system (for rechargeable devices)
   If you have a rechargeable battery, you will be given equipment to charge it at home.

• The controller and charger should be added to your household insurance in case of loss or damage.
• If your device is rechargeable, it must be charged regularly and must ot be allowed to fully discharge.

What does spinal cord stimulation feel like?

People experience SCS differently. Many patients do not feel any sensation from the SCS, as it uses very high‑frequency stimulation. However, if patients can feel it, the sensation is typically described as a comfortable and pleasant tingling.

Some newer devices do not produce a tingling sensation but still provide pain relief.

How are the leads placed?

In most cases, the leads are inserted into the epidural space using a needle. This area runs from your neck down the length of your spine and contains nerves that connect to the rest of your body.

The procedure is usually performed under sedation, so you are comfortable but able to respond. X-ray guidance is used to ensure accurate positioning.

Surgically placed leads

In more complex cases, a surgical procedure under general anaesthetic may be required. This would be discussed with you in advance. The procedure may involve both a pain specialist and a spinal surgeon. In some circumstances, referral to another hospital may be necessary.

Where is the battery placed?

The battery is most commonly implanted in the upper outer buttock. In rare cases, it may be placed in the lower abdominal area. The most suitable position will be discussed with you in clinic.

Will I feel the device under my skin?

While your wounds are healing, it is normal to feel some tenderness or discomfort. This should improve over time.

Once healed, most people are aware of the device only when pressing over the area. The battery is usually placed 1–2 cm beneath the skin to allow effective charging.

Living with a Spinal Cord Stimulator

Do I need to use it all the time?

The majority of patients use their SCS all the time. You might have a few different programmes to switch between for daytime or night time use, but the common practice is to keep the system on at all times. You may have a silent programme (where there is no sensation) or a tonic programme (where you feel tingling).

Can I adjust the settings myself?

Yes. You will be shown how to turn the device on and off and how to adjust the intensity within safe limits.

Your stimulator will be programmed specifically for you. Settings can be adjusted at follow-up appointments if needed.

Can I shower or swim?

You may shower once your wounds have fully healed.

Swimming should be avoided until approximately 6–8 weeks after implantation, or until advised by your clinical team.

Usually, you do not have to switch SCS off during swimming.

Is it safe to use household appliances?

Yes. Everyday household items such as microwaves, computers and mobile phones are safe to use.

Security systems (for example in shops or airports) and strong magnets may temporarily affect your stimulator. They may change the sensation or switch the device off. This will not damage it.

We recommend turning the stimulator off when passing through security gates or theft detectors.

Can I drive?

It is safe to drive if you are using a silent programme, there is no need to switch the SCS off. If you use tonic (programme where you feel tingling), you should switch it off or change to a silent programme before driving or operating heavy machinery.

You must inform the DVLA and your motor insurance provider that you have an implanted device.

You may travel as a passenger with the stimulator on with any programme.

Can I return to work?

This depends on the type of work you do and how well your pain is controlled. Your pain specialist will discuss this with you and advise accordingly.

Can I travel?

Yes. You will be given an identification card after your implant. You should carry this with you at all times, especially when travelling.

Metal detectors may detect your device. Show your ID card to security staff if needed.

When flying:

• Switch the stimulator off during take-off and landing.
• Follow any instructions given by the flight crew.
• There is no need to switch the device off during turbulence.

Is it safe to have sex?

Yes. Once your wounds have fully healed, it is safe to resume sexual activity.

During the early recovery period (usually the first 6–8 weeks), you should avoid sudden twisting, stretching or excessive bending to allow the leads to settle securely. Your clinical team will advise you when it is safe to return to normal activities.

Some people prefer to switch the stimulator off during sexual activity, particularly if changes in position alter the stimulation sensation. This is a personal choice.

If you experience discomfort around the battery site, you may wish to adjust positions to avoid direct pressure over the implant area.

Is it safe to exercise?

Gentle movement and light activity are encouraged after your procedure, as advised by your pain team. Please see our separate leaflet for specific information on this. There are certain restrictions to follow.

How can I make the battery area more comfortable?

It is common to have some tenderness or awareness of the battery site while healing takes place. This usually improves over several weeks.

The following may help:

• Wearing loose-fitting clothing to avoid pressure on the area
• Avoiding belts or tight waistbands over the implant site
• Using a small cushion or padding when sitting for long periods
• Adjusting your sleeping position to avoid lying directly on the battery

The device is placed just beneath the skin (usually 1–2 cm deep) to allow charging, so some awareness of the implant is normal.

If you experience:

• Increasing pain
• Redness or swelling
• Persistent discomfort beyond the healing period

Please contact the Pain Management Centre for advice.

Who will look after me after my implant?

You will remain under the care of the Pain Management Centre at Cambridge University Hospitals NHS Foundation Trust.

Follow-up is usually arranged at:

• 1 month
• 3 months
• 6 months
• 9 months
• 12 months

After this, you will normally be offered annual reviews.

Who do I contact if I have equipment problems?

If you experience technical problems with your stimulator, charger or controller, please contact the Pain Management Centre via the secretaries’ number on clinic letters. Messages can be left on the answerphone service if necessary. Please note we are not a 24 hour service.

Medication

Bring all of your medicines (including inhalers, injections, creams, eye drops or patches) and a current repeat prescription from your GP

Please tell the ward staff about all of the medicines you use. During your stay If you wish to take your medication yourself (self-medicate) please speak with your nurse. Pharmacists visit the wards regularly and can help with any medicine queries.

MyChart

We would encourage you to sign up for MyChart. This is the electronic patient portal at Cambridge University Hospitals that enables patients to securely access parts of their health record held within the hospital’s electronic patient record system (Epic). It is available via your home computer or mobile device

More information is available on the My Chart section on our website.

Contacts/further information

Please contact the Pain Management Centre via the secretaries’ number on clinic letters. Messages can be left on the answerphone service if necessary. Please note we are not a 24 hour service.