A Spinal Cord Stimulator (SCS) is an implanted device that manages chronic pain by delivering mild electrical impulses to the spinal cord, interrupting pain signals before they reach the brain. The device consists of a small battery-powered generator placed under the skin and thin wires, or leads, positioned near the spinal cord. Understanding the recovery process following implantation surgery is crucial for the device’s success and optimal healing. This guide outlines what to anticipate after the procedure, focusing on physical recovery and device management.
Immediate Post-Operative Care and Discharge
Following the procedure, patients are moved to a recovery area where medical staff monitor vital signs as the effects of anesthesia wear off. Grogginess and nausea are common initial experiences, which the recovery team manages with medication. The length of the hospital stay varies; many patients are discharged the same day, while others may require an overnight stay for observation and pain management.
Before discharge, patients receive instructions on using the handheld controller and managing the device. Mobility begins almost immediately, starting with gentle walking with assistance to prevent stiffness and promote circulation. Discharge requires reliable transportation, and patients are not permitted to drive themselves due to the lingering effects of anesthesia and pain medication.
Managing Incision Healing and Pain
The SCS procedure results in two surgical sites: a small incision over the spine where the leads were inserted, and a larger incision where the internal pulse generator (IPG) or battery was placed, usually in the buttock or abdomen. Swelling, bruising, and tenderness at both sites are expected during the first week as the body heals. Post-surgical discomfort is managed with prescribed pain medication, which is intended to reduce, but not eliminate, all pain.
Wound care requires keeping the incisions clean and dry to minimize infection risk. Patients may be instructed to take sponge baths for the first few days, avoiding showering until 48 to 72 hours after the procedure. Soaking the incisions (in a bathtub, pool, or hot tub) must be avoided for at least two to four weeks to allow the wounds to seal. Patients must monitor the sites daily and contact their surgeon immediately if they notice concerning signs like spreading redness, warmth, excessive drainage, or a fever above 101°F.
Activity Restrictions and Return to Normal Life
The most critical period involves strictly adhering to activity restrictions to prevent the leads from migrating. Lead migration can cause a sudden loss of stimulation or a change in the pain relief area, potentially requiring a second procedure to reposition the wires. For the first six to eight weeks, patients must avoid movements that significantly strain the back.
Specifically, the “BLT” restrictions—Bending, Lifting, and Twisting—must be followed. Lifting is limited to no more than five to ten pounds, roughly the weight of a gallon of milk. Patients should use a “log-rolling” technique to get in and out of bed and bend at the knees while keeping their back straight when picking up light items.
Timelines for resuming daily activities depend on the individual’s healing rate and the nature of the activity. Driving is prohibited for one to two weeks, or until the patient is no longer taking prescription pain medications that impair reaction time. Return to work depends on the job’s physical demands; those with sedentary jobs may return within a few weeks, while those with strenuous jobs may need the full six to eight weeks of restriction. Sexual activity can resume when the patient feels comfortable, provided caution is used to avoid twisting or excessive movement in the implant area.
Initial Programming and Long-Term Follow-Up
The spinal cord stimulator may be partially activated before leaving the hospital, but fine-tuning the therapy settings occurs over several appointments. The initial programming session, which often takes place two to four weeks after surgery, involves meeting with a clinical representative specializing in the device. During this meeting, various electrical settings, such as pulse width and frequency, are tested to maximize pain relief coverage and comfort.
The goal of these early sessions is to create multiple programs the patient can switch between using their remote control, optimizing stimulation for different activities or times of day. Subsequent follow-up appointments are scheduled over the next few months to monitor the surgical sites and make further programming adjustments as the patient’s body adapts. For patients with rechargeable batteries, maintenance involves routine recharging. Non-rechargeable generators will eventually require a replacement procedure, typically every five to ten years, depending on the device and usage.