If you've tried medication, physical therapy, and maybe a few injections, and the pain still hasn't gone away, that's frustrating, and it's more common than you'd think. Some treatments may help for a while, then the pain comes back. Others barely make a dent.
When this happens, doctors usually start talking about more advanced options. One of these is spinal cord stimulation, which may help certain patients with chronic pain who haven't found adequate relief with more conservative treatments. Here's why chronic pain can be so hard to treat, what advanced options exist beyond medication, and how spinal cord stimulation therapy LA actually works for the right patients.
Why Some Chronic Pain Conditions Persist
Chronic pain doesn't always reflect ongoing tissue damage. In some cases, the original injury has healed, but the nervous system continues to send pain signals. A few common reasons this happens:
-
Nerve damage —conditions such as peripheral neuropathy, persistent nerve injury, or some cases of sciatica can cause nerves to continue sending pain signals even after the original problem has improved or been treated.
-
Failed back surgery syndrome - Some people continue to experience chronic pain or develop new pain after spine surgery, despite technically successful procedures.
-
Complex regional pain syndrome (CRPS) —This condition often develops after an injury or surgery and may cause severe, persistent pain that's disproportionate to
the original injury. It can also spread beyond the initially affected area.
-
Long-term pain changing the nervous system — Persistent pain can make the nervous system more sensitive over time, a process known as central sensitization. As a result, the body may continue to amplify pain signals even after tissues have healed.
None of this means the pain isn't real. It means the nervous system may continue to send or amplify pain signals, which is one reason medication alone isn't always enough to manage chronic pain.
Advanced Therapies Available Beyond Medication
When medications, physical therapy, and other conservative treatments haven't worked, there are other treatment options most people don't hear about until they are referred to a specialist.
-
Treatment How It Works
Best For Radiofrequency ablation Uses heat to interrupt pain signals by targeting specific nerves. Chronic back or neck
painNerve blocksInjection targets a specific nerve or nerve groupDiagnosing and treating localized painIntrathecal drug deliveryDelivers medication directly into the fluid surrounding the spinal cord using much smaller doses.Patients needing strong pain relief with fewer side effectsSpinal cord
stimulationA small, implanted device delivers mild electrical impulses that modify how pain signals are transmitted to the brain.
Chronic nerve pain, failed back surgery, CRPS
These therapies are generally considered after conservative treatments haven't provided adequate relief. For carefully selected patients, they may help improve pain and function when medications alone aren't enough.
How Spinal Cord Stimulation May Help Certain Patients
Spinal cord stimulation works differently from most pain treatments. Instead of treating inflammation or directly numbing painful tissues, spinal cord stimulation changes the way pain signals are transmitted and processed before they reach the brain. A small device, located near the spine, sends mild electrical pulses. Depending on the type of device and programming, some patients experience a mild tingling sensation, while newer systems may provide pain relief without any noticeable sensation.
This treatment isn't for everyone, and a good specialist will tell you that upfront. After appropriate conservative treatment has failed, it tends to help patients dealing with:
-
Chronic back or leg pain
-
Failed back surgery syndrome
-
Complex regional pain syndrome (CRPS)
-
Certain types of ongoing nerve pain
Before getting a permanent device, patients go through a short trial first. A temporary device is placed for about a week, so the patient can see how much it actually helps in daily life, not just in a clinic visit. If the trial provides meaningful pain relief and improved function, a permanent device can be implanted through a minor outpatient procedure. Patients also control the settings themselves with a small remote.
This trial-first approach is a big part of why spinal cord stimulation therapy LA patients ask about tends to feel like a safer option. Nothing permanent happens until there's proof it actually helps.
Conclusion
Chronic pain that doesn't respond to normal treatment can feel discouraging, but it doesn't mean you're out of options. If medication, therapy, and injections haven't given you lasting relief, advanced treatments such as spinal cord stimulation may be appropriate for certain types of chronic pain that haven't responded to more conservative therapies.
If you've reached that point, talk to a specialist offering spinal cord stimulation therapy at Tops Doctors, and find out if this could be an appropriate next step in your treatment plan.
1. Is spinal cord stimulation something you have to keep forever once it's put in?
Not necessarily. If it's not helping, or you just don't need it anymore, the device can usually be removed if it's no longer providing enough benefit or is no longer needed. And before you even get to that point, you'll try it out temporarily first, so you get to test the therapy before the initial implant.
2. What does it actually feel like when it's turned on?
Some people notice a light tingling in the area where the pain used to be. Some of the newer devices don't give you any sensation at all; they just quietly do their job in the background.
3. Am I even a good fit for this kind of treatment?
You may be a candidate if you've been living with chronic back or leg pain, failed back surgery syndrome, CRPS, or certain types of nerve pain that haven't responded to other treatments. A pain specialist can determine whether spinal cord stimulation is appropriate for your condition.
4. How long do I have to wear the trial device before deciding?
The trial typically lasts about 5 to 7 days, although the exact duration may vary depending on your physician's recommendation.
5. Will my insurance actually pay for this?
Many insurance plans, including Medicare and numerous commercial insurers including PPO commercial insurances (examples: Aetna, Blue Cross, Blue Shield, United Healthcare, Cigna, and others), cover spinal cord stimulation for appropriate candidates who meet medical necessity criteria. Coverage varies by plan, so your doctor's office can help verify your benefits before treatment.