Spinal Cord Stimulation (SCS) in Castle Rock

Medical author: Eduardo Carrera, MD. Double Board-Certified in Pain Medicine and Physical Medicine & Rehabilitation (PM&R).

What is an SCS trial?

An SCS trial is a short-term “test drive” of spinal cord stimulation. During the trial, thin temporary wires (leads) are placed through a needle into the space near the spine. The leads connect to a small external battery that you wear on a belt or waistband for 5-7 days.

The goal is to see how much your pain, function, and daily activities improve with stimulation before anyone considers a permanent implant.

If the trial is successful and you decide to move forward, Dr. Carrera will coordinate a referral to a trusted surgical colleague who performs the permanent implant.

How does SCS help pain?

SCS does not “fix” a disc or repair a nerve. Instead, it changes (modulates) how pain signals are processed in the nervous system. Many people feel less pain, less “electric” nerve pain, and better ability to move and do daily activities when the stimulation is on.

Different devices use different stimulation patterns (for example, traditional low-frequency or higher-frequency stimulation). You do not need to choose a specific device before your trial; the trial is about whether the therapy helps you.

Who is the trial for?

SCS is most often considered for chronic nerve-type pain that has not improved enough with appropriate conservative care and/or prior procedures. Common examples include:

·         Chronic back and leg pain after spine surgery (sometimes called persistent spinal pain syndrome or “failed back surgery syndrome”).

·         Complex regional pain syndrome (CRPS).

·         Painful diabetic neuropathy (burning, tingling, or shooting pain in the feet/legs).

·         Selected cases of chronic nonsurgical low back pain after a careful evaluation.

SCS is not right for everyone. During your clinic visit, Dr. Carrera will review your diagnosis, imaging, medications, and prior treatments. Some patients also need a brief psychological screening (often required by insurance) to make sure SCS is a safe and appropriate next step.

What does the science say?

In higher-quality studies (including randomized controlled trials) for certain conditions, SCS has been shown to improve pain and function compared with medical management alone in appropriately selected patients. Outcomes vary. The trial is important because it helps predict whether you, personally, are likely to benefit.

If you want to read more, a list of selected studies and guidelines is included at the end of this handout.

What to expect: the SCS trial procedure

This is typically an outpatient procedure. The visit is usually under 2 hours, and the procedure itself is commonly 20–45 minutes.

1.       Check-in and preparation. We review medications, allergies, and the plan for the day. Nursing staff places an IV.

2.       Numbing medicine. The skin is cleaned and numbed. You may receive light sedation depending on your situation.

3.       Lead placement with X-ray guidance. Dr. Carrera places one or more temporary leads through a needle and confirms positioning with live X-ray.

4.       Programming. A device specialist helps program stimulation settings so you can test what feels best.

5.       Going home with the external battery. You wear the external battery for several days and keep a simple daily log of pain and function.

How we decide if the trial is “successful”

We focus on real-life improvements, not just a number on a pain scale. A trial is often considered successful when you have both:

·         Meaningful pain relief (often about 50% or more), and

·         Better function (for example: walking farther, standing longer, sleeping better, needing fewer rescue medications, or returning to activities you care about).

Before your trial starts, we will ask you to choose specific goals so we can judge the outcome clearly (for example: “walk 20 minutes,” “sleep through the night,” or “ride in the car for 45 minutes”).

What happens after the trial?

At the end of the trial, the temporary leads are removed in clinic (usually quickly and with minimal discomfort). Then:

·         If the trial helps: Dr. Carrera will review your results with you and, if you want to proceed, connect you with a surgical colleague who can perform the permanent implant. Our team shares your trial data and coordinates next steps.

·         If the trial does not help enough: We do not proceed with an implant. Dr. Carrera will discuss other options tailored to your diagnosis (medications, therapy, injections/ablations, minimally invasive procedures, or referral as needed).

Activity restrictions during the trial

To reduce the risk of the leads moving, most patients should follow these restrictions while the trial leads are in place:

·         No bending, twisting, heavy lifting, or overhead reaching.

·         Avoid strenuous exercise and avoid soaking the dressing (no baths, hot tubs, or swimming).

·         Keep the dressing clean and dry. Follow the specific instructions you are given the day of the procedure.

Risks and safety

Serious complications are uncommon, but any procedure has risk. Trial-related risks may include:

·         Soreness at the insertion site.

·         Bleeding or bruising.

·         Infection (rare, but important to watch for).

·         Headache (especially if there is a spinal fluid leak; uncommon).

·         Lead movement, which can reduce benefit and may require repositioning or ending the trial early.

Call us urgently or go to the ER if you develop fever, worsening redness or drainage at the site, new weakness, loss of bowel/bladder control, or severe headache that is not improving.

Common questions

1. Will the trial hurt? Most patients feel pressure and brief discomfort, but we use numbing medicine and can use light sedation when appropriate.

2. Can I drive during the trial? Often not on the day of the procedure (especially if sedated). During the trial days, ask our team; it depends on your symptoms and your medication use.

3. Can I work during the trial? Many people can do light work, but avoid physical tasks that bend, twist, lift, or strain.

4. Do I have to stop my medications? Not always. Dr. Carrera will give you specific instructions. You will need to stop blood thinners, but we will discuss how to do this safely.

5. If the trial works, does the implant guarantee the same result? A successful trial is a good sign, but outcomes can still vary. We use the trial plus your overall medical picture to make the best decision.

Selected references (for patients who want to read more)

·         Shanthanna H, Eldabe S, Provenzano DA, et al. Evidence-based consensus guidelines on patient selection and trial stimulation for spinal cord stimulation. Regional Anesthesia & Pain Medicine. 2023.

·         Kapural L, Yu C, Doust MW, et al. 10-kHz high-frequency SCS compared with traditional low-frequency SCS for chronic back and leg pain: randomized controlled trial (SENZA-RCT). Anesthesiology. 2015.

·         Petersen EA, Stauss TG, Scowcroft JA, et al. 10-kHz spinal cord stimulation for painful diabetic neuropathy: randomized clinical trial. JAMA Neurology. 2021.

·         Deer TR, Levy RM, Kramer J, et al. Dorsal root ganglion stimulation vs spinal cord stimulation for complex regional pain syndrome: randomized trial (ACCURATE). Pain. 2017.

·         North American Neuromodulation Society (NANS). Spinal Cord Stimulation - patient information. Accessed December 20, 2025.

·         North American Spine Society (NASS). Coverage recommendations for spinal cord stimulation. (Check most current version).

Last reviewed: December 20, 2025