Spinal Cord Stimulator Trial: What You Need to Know

Unlike other chronic pain treatment options or surgery, with a spinal cord stimulator trial, you can try a temporary system first and see if spinal cord stimulation helps relieve your pain before you decide to move forward with an implant. For many people, the trial turns out to be an eye-opening experience that opens the door to long-term pain relief and leads to newfound freedom from chronic pain.

Spinal cord stimulation can be a very effective approach to managing severe chronic pain, especially for people who haven’t found pain relief with other treatment options.

There’s a lot to think about when deciding to try spinal cord stimulation. Here are the most asked questions about a spinal cord stimulator trial and the answers.

Question #1: Is a spinal cord stimulator trial covered by insurance?

The short answer is yes. A spinal cord stimulator trial, even though it’s temporary, is covered by nearly all major insurance plans, including Aetna, Humana, United, Blue Cross Blue Shield, and Medicare for appropriate candidates.

Most states’ Medicaid policies as well as worker’s compensation cover spinal cord stimulator trials. Also, spinal cord stimulator trials are available for veterans at select VA and military hospitals across the US.

As you evaluate if trying a spinal cord stimulator could be the next step for you, it’s important to take some time to review any questions specifically related to your coverage options with your insurer and pain management provider. Find more information about insurance and spinal cord stimulator costs here. 

Question #2: How long is a spinal cord stimulator trial?

The trial period is typically about 5 to 7 days.

The length of your trial usually depends on how your pain responds during the trial and what’s best for your specific treatment plan.

Question #3: How does a spinal cord stimulator trial work?

During the trial, you’ll have the chance to experience the same pain-relieving therapy as the implant, but with a temporary device. The trial procedure is quick, simple, and outpatient. It’s very similar to an epidural injection and it’s usually performed in your doctor’s office.

Then the temporary device is taped to your back and is easily hidden under your clothes.

If you get at least 50% pain relief during your trial, then you’ll have the option to move forward with the implant. Learn more about how spinal cord stimulation works:

Question #4: Does a spinal cord stimulator trial hurt?

A spinal cord stimulator trial doesn’t require any incisions; however, it does involve using a small needle to place the leads – very similar to an epidural injection. Your physician will numb the area for comfort however you may have temporary pain at the site once the local anesthesia wears off. After this time passes (usually about 48 hours), most people don’t experience any procedural discomfort during the rest of the trial.

Question #5: What is the recovery? Are there any restrictions after a spinal cord stimulator trial?

Because the temporary system has an external battery, there are a few precautions you may need to take. Your doctor will provide specific instructions at the time of your trial, but generally, you should avoid:

• Activities with twisting, bending or lifting your arms above your shoulders
• Lifting heavy objects
• Getting your trial battery wet (don’t swim or shower)

You and your doctor will work together to determine if you have any additional restrictions. Like any medical procedure, it’s important to closely follow the advice of your doctor.

Most people can continue to go about their daily routine with only a few minor restrictions. The trial is a time for you to evaluate your pain relief, improvement to your daily activities, and see if spinal cord stimulation helps you meet your pain management goals.

Generally, you’ll be encouraged to maintain your daily routine and even try activities your pain has prevented you from doing like walking, sitting, standing, shopping, etc.

Question #6: How will I know if my spinal cord stimulator trial is successful?

The goal of a spinal cord stimulator trial is for you to see if it can effectively help manage your pain. A successful trial is defined by the percent of pain relief you’re experiencing, your ability to complete daily activities, the need for pain medication, and if you’re able to relax and sleep better.

You can make a list of small goals you’d like to achieve if you had less pain.  For example, one goal may be to shop for groceries without taking a break or stand and comfortably do the dishes longer. You’ll want to ask yourself questions like can I get out of bed easier? Am I walking with less pain?  Am I waking up less in the middle of the night?

You could even keep a journal to help track how successful your trial is. You can go about your normal day while also jotting down specific details about how you’re feeling and if you’re able to complete takes more easily.

To help evaluate your spinal cord stimulator trial, we recommend you track improvement in:

• Pain scores
• Sleep quality
• Pain medication needs
• Ability to complete tasks and activities
• Anything new you’re able to do
• Emotional well being

Before you decide on whether spinal cord stimulation is the right treatment option for you, it’s important to consider if the pain relief you experienced during the trial, both while active and resting, will translate into long-term improvement in your overall quality of life.

You and your doctor will work together closely to see if moving forward with the implant is the right option, but most people move forward if they experience at least 50% pain relief.

Question #7: Will I feel the stimulation during the trial?

The answer to this question depends on which spinal cord stimulator device you choose to try.

Most traditional spinal cord stimulators use paresthesia, or a tingling sensation like a TENS unit, to mask pain signals and for some people, this can be an uncomfortable feeling.

However, HFX™ spinal cord stimulation offers programs without this tingling sensation; allowing you to just feel relief.

Question #8: Is spinal cord stimulation safe?

Yes, spinal cord stimulation has been a well-established approach to managing chronic pain for over 50 years.  It safely relieves chronic pain without interfering with your normal sensory perception, cognitive abilities, or motor functions.

It also doesn’t interact with any medications, and it has significantly fewer side effects than other treatment options.

Spinal cord stimulation isn’t a major surgery and is typically safer than spine surgeries used to address chronic pain^1-2,3-5. The trial system is very easy to remove and often takes less than a minute.

The safety of newer devices like HFX has been thoroughly studied and proven and HFX has a very similar safety profile to other SCS devices that have been available for many years^1-2,6.

Question #9: Will I experience the same relief from the trial with the implant?

The trial system delivers the same therapy you’ll experience with the actual implanted device, making the trial the best guide to how much pain relief you’ll experience with the implant.

See what physicians are saying about the relief their patients are experiencing with HFX spinal cord stimulation here:

Hear first hand from Rod about his experience with HFX spinal cord stimulation:

Question #10: Are all spinal cord stimulators the same?

It’s important to know that not all spinal cord stimulator devices offer the same therapy options and features. HFX, the most advanced spinal cord stimulator available, has multiple key benefits not offered by other traditional spinal cord stimulators:

• No tingling – HFX offers programs without a tingling sensation (paresthesia).
• 24-hour pain relief – HFX offers programs without driving or sleeping restrictions.
• Full-Body MRI Access⁷– HFX is compatible with full-body MRI scans so you can receive the care you need. Not all spinal cord stimulators have the same MRI access.
• Designed for 10+ battery life without programming restrictions⁸ – Many other systems, especially non-rechargeable, require you to use a narrow set of low-frequency therapy programs to achieve a 10-year battery life. This limits your therapy options and could lead to additional surgeries and insurance requests for battery replacements, often within 2-5 years.
• The widest range of frequencies and waveforms available for customized long-term relief – Traditional spinal cord stimulation can only offer low frequencies programs. HFX uniquely offers both 10,000 Hz high-frequency therapy and 2-1,200 Hz low-frequency therapy for the best possible pain relief.

It’s important to think about choosing a spinal cord stimulator that can provide you with a comprehensive solution to treat the complex and dynamic nature of chronic pain.

HFX offers the most programming flexibility and access to the most frequencies and waveforms for a customizable solution to your chronic pain. 9 out of 10 people who try HFX, get enough relief to stay with it⁶. Learn more about what to expect with HFX.

If you are considering trying a spinal cord stimulator and would like to learn more about advanced stimulators like HFX, the first step is to take a short assessment today. At the end, you can request a call from an HFX Coach who will answer any questions you have and help you find an HFX-trained doctor in your area.

If you’re currently working with your pain management provider about spinal cord stimulation, at your next appointment ask if newer options like HFX offered by Nevro could be a better option for you.

Summary

• Unlike other chronic pain treatment options, you can try a spinal cord stimulator to make sure you experience relief
• A spinal cord stimulator trial can be eye-opening and may lead to newfound freedom from chronic pain
• Not all spinal cord stimulator devices are the same – it is important to think about choosing a spinal cord stimulator that can provide you with a comprehensive solution
• 9 out of 10 people who try HFX, get enough relief to stay with it.

Sources

1. Kapural L, et al. Comparison of 10-kHz High-Frequency and Traditional Low-Frequency Spinal Cord Stimulation for the Treatment of Chronic Back and Leg Pain: 24-month Results from a Multicenter, Randomized, Controlled Pivotal Trial. Neurosurgery. Published 09 2016 [Epub ahead of Print]. 
2. Stauss, Thomas et al. A Multicenter Real-World Review of 10kHz SCS Outcomes for Treatment of Chronic Trunk and/or Limb Pain. Annals of Clinical and Translational Neurology. January 2019 (Currently in Press) 
3. Mirza, Sohail K, and Richard A Deyo. “Systematic review of randomized trials comparing lumbar fusion surgery to nonoperative care for treatment of chronic back pain.” Spine vol. 32,7 (2007): 816-23. doi:10.1097/01.brs.0000259225.37454.38 
4. Smith, Justin S et al. “Complication rates of three common spine procedures and rates of thromboembolism following spine surgery based on 108,419 procedures: a report from the Scoliosis Research Society Morbidity and Mortality Committee.” Spine vol. 35,24 (2010): 2140-9. doi:10.1097/BRS.0b013e3181cbc8e7 
5. Deyo, Richard A et al. “Trends, major medical complications, and charges associated with surgery for lumbar spinal stenosis in older adults.” JAMA vol. 303,13 (2010): 1259-65. doi:10.1001/jama.2010.338 
6. Kapural L., et al. Novel 10-kHz High-frequency Therapy Superior to Traditional Low-frequency Spinal Cord Stimulation for the Treatment of Chronic Back and Leg Pain. Anesthesiology, 123(4)
7. Senza MRI Guidelines.
8. Senza Summary of Safety and Effectiveness Data (SSED). Published May 8 2015.