A Spinal Cord Stimulator (SCS) is an implanted medical device used to manage chronic pain by delivering electrical impulses directly to the spinal cord. This electrical current interrupts or masks pain signals traveling to the brain, offering relief when other treatments have failed. For individuals with this technology, the ability to return to normal activities, such as swimming, is a frequent concern. Whether a person can swim with an SCS depends on the type of device and the stage of the treatment process.
Distinguishing Between SCS Device Types
The most significant factor determining water safety is the difference between the temporary trial phase and the permanent implant. During the SCS trial, the pulse generator and battery are worn externally, often secured to a belt. Because the leads are temporarily placed through the skin, contact with water is strictly prohibited to prevent electrical shorting and infection at the insertion site. Patients are instructed to avoid showering, bathing, or swimming, and must rely on sponge baths to keep the area clean and dry until the temporary leads are removed.
Once a successful trial leads to a permanent system, all components—the battery, leads, and generator—are surgically implanted beneath the skin, eliminating the risk of external shorting. After the surgical incisions have fully healed, typically four to eight weeks, swimming is generally considered safe and encouraged as a low-impact activity. However, even with a fully implanted device, certain water-related activities carry specific risks related to pressure changes and device integrity.
Water Safety Guidelines for Permanent Implants
For a fully healed, permanent SCS implant, the primary restriction involves the depth of submersion. Scuba diving and deep-water activities are generally discouraged because the increased hydrostatic pressure can potentially damage the device’s casing or cause the leads to shift out of position. Manufacturer guidelines often recommend avoiding depths below 10 meters (33 feet) and advise against entering hyperbaric chambers above 2.0 atmosphere absolute (ATA) for the same reason.
Swimming in common environments, such as chlorinated pools, freshwater lakes, or the ocean, is acceptable once the surgical sites are completely closed and healed. The integrity of the implanted device is designed to withstand normal water exposure, but prolonged immersion should be discussed with a physician. It is important to avoid soaking in hot tubs or baths during the initial healing period, which is typically around two weeks after the permanent implant surgery.
For patients with rechargeable SCS systems, post-swim care should focus on the skin area covering the implanted battery. Although the device itself is sealed, the skin should be thoroughly dried before using an external charging pad to ensure optimal connection and prevent skin irritation. Following any swim, inspect the incision sites, even if healed, to ensure no new irritation has developed.
Recognizing Signs of Device Complications
Even after full recovery, be aware of signs that may indicate a problem with the device following physical or water activity. Signs of an infection at the implant site require immediate medical attention and include increased redness, warmth, swelling, or tenderness. A fever greater than 100.4 degrees Fahrenheit, discharge, or foul odor from the incision area are serious signs of a potential issue.
Device malfunction may manifest as a sudden, severe increase in pain or the complete loss of the expected electrical stimulation. Patients may also experience unexpected, uncomfortable shocks, a burning sensation, or stimulation that feels intermittent or occurs in the wrong area. These symptoms suggest an issue with the generator or the electrical connection.
Changes in sensation below the level of the implant can signal lead migration, where the thin wires have shifted from their intended position near the spinal cord. Symptoms of lead movement include new or worsening pain, or the sudden onset of numbness, tingling, or muscle weakness. These signs warrant a prompt call to the physician to prevent further complications.