Spinal Cord Stimulation (SCS): The Kent Centre for Pain Medicine and Neuromodulation

This leaflet will give you information about spinal cord stimulation (SCS) to help with the management of your chronic pain.

We hope this leaflet answers some of the questions you may have. If you have any further questions or concerns, please speak to your pain consultant or a member of your healthcare team.

Why have I been recommended for SCS?

Your pain consultant has recommended spinal cord stimulation (SCS) to help with the management of your chronic pain. SCS does not cure chronic pain, but it can help to reduce your pain when used alongside medication and other treatments.

SCS insertion is a surgical procedure / operation. It is important that we outline the risks and benefits before you decide whether SCS is the right treatment for you.

What is SCS? And, how does it work?

We use SCS to treat people who suffer from chronic (long-term) neuropathic (nerve) pain. The nerves in your spinal cord carry messages to your brain telling it you feel pain in certain areas. We insert a lead (electrode) inside your spine, which applies an electric current to your spinal cord. The current interrupts the pain messages that your brain receives.

Depending on which system we use, you may feel a pleasant sensation (called paraesthesia). Some patients describe this as tingling, warm feeling, or a pins and needles feeling over the area of the pain. However, if we use ‘high-frequency’ stimulation you may not feel any paraesthesia at all.

We will give you a remote control which allows you to:

• turn the stimulation on and off

• switch between programmes

• increase or decrease the sensation that you receive

If you have paraesthesia, you cannot use the stimulation when driving.

This treatment should mean that you can reduce the amount of painkillers you need to take for your pain. We aim to work with you so that you can control your pain and are able to increase your movement and exercise.

What are the different types of SCS?

There are many different types of stimulation, including the following.

• Low frequency SCS, which may give a tingling sensation in the painful area. This is known as paraesthesia.

• High frequency SCS, which is usually not felt at all.

• Dorsal root ganglion stimulation, which targets a very specific area of neuropathic pain, such as the foot.

Your consultant will decide which system is best for you, before they refer you for SCS. They base their decision on many factors including:

• where your pain is

• the type of pain you have

• your medical history

Who decides whether SCS is the right treatment for me?

After your pain consultant refers you for SCS, members of a multidisciplinary team (MDT) will assess you.

• Most SCS patients are invited to one of our SCS Group Education Sessions. These sessions last 4 hours. We encourage you to bring a friend or relative with you. The sessions are run by:

  • a clinical nurse specialist

  • an occupational therapist

  • a psychologist, alongside a representative of the SCS company

  We will send you an assessment booklet before you come to the session. Please complete and bring this booklet with you on the day. We will also send you literature about the procedure. We need you to complete the assessments so we can complete the assessment process. If you do not complete them, you will not be able to progress along the SCS pathway. We expect you to complete these assessments at intervals throughout your SCS pathway.

• Some of the aims of the session.

  • Provide information about the pathway, the procedure, and the equipment.

  • Discuss possible risks and benefits to having the procedure.

  • Help you to consider some realistic ‘SMART’ goals.

  • Help you to meet other patients who have similar experiences to you.

  • Provide support in decision making, and help you to give informed consent for any future procedures.

  • Explore how you are managing your pain right now, and your expectations of SCS.

  • Discuss how you would feel if SCS does not work for you.

  • Explore what other options are available if SCS is not for you.

• After the education session, your case will be discussed by the MDT. This is to make sure SCS is the right treatment for you. A member of the MDT will contact you by telephone at the end of the day to let you know the outcome of your assessment. They will let you know if:

  • we are able to offer you a date for the SCS procedure; or

  • if you need further appointments with a member of the Pain team.

• Rarely, a patient needs an individual appointment rather than a group session. If this happens, there will be several appointments which you must go to. At these appointments you will see one of the clinical nurse specialists (CNS). The CNS will explain in more detail what is involved and give you a chance to ask questions.

• We will refer you to a psychologist. They will help you explore any thoughts, feelings, or expectations you may have about SCS. The psychologist may also introduce you to some helpful psychological approaches to help manage your pain.

• We will also refer you to an occupational therapist, to assess your functional abilities. This will include pacing your activities before and after your procedure.

It is very important that you:

• come to all your appointments; and

• complete all the questionnaires that we give you at these appointments.

Who cannot have SCS?

If you experience any of the following you should not have SCS.

• Pain that SCS will not help, for example pain due to arthritis.

• Pain beyond the area that SCS can cover (widespread pain syndromes).

• Physical problems that mean it is not possible to safely implant a SCS. For example:

  • major spinal deformity

  • extensive spinal metalwork

  • extensive spinal scar tissue in your epidural space

• An active infective illness.

• Some chronic (long-term) medical illnesses. For example multiple sclerosis (MS) or severe respiratory disease.

• Some psychiatric illnesses.

• A very high or very low body mass index (you are either very over or underweight).

• Excessively use alcohol, prescription drugs, and / or recreational drugs.

• Are on high doses of opioids.

• Are allergic to any parts of the implantable device.

What happens once it is decided I am suitable for SCS?

Once we decide you are suitable and ready for SCS, we will offer you a trial of the stimulation to see if it works for you. Or we may feel that you are suitable to proceed direct to a full implant.

What happens at the trial stage?

We perform the trial stage as a day case in the Day Surgery Unit.

• We insert the lead (either one or two) through a needle in the lower part of your back. You will be under deep sedation, so you will sleep during most of your treatment.

• We remove the needle, leaving the end of the lead exposed underneath a dressing.

• The lead is connected to a small pulse generator (a battery the size of a pocket watch). The generator delivers your stimulation.

• We will give you different programmes to try, and a remote control. These allow you to adjust the stimulation at home.

The trial stage lasts for 2 weeks. After this time, you will come back to clinic to have the lead removed. The procedure is painless. Depending on how your trial has gone, the team may offer to extend your trial using the same trial leads, and possibly with a different system.

What does the permanent implant involve?

If your trial was successful or you have gone straight to a full implant, we will arrange for you to come back for the permanent implant. Please be aware this will be at least 6 to 8 weeks after your trial.

The full implant is also performed as a day case in the Day Surgery Unit.

• We insert the lead (either one or two) through a needle in the lower part of your back. You will be under deep sedation, so you will sleep during most of your treatment.

• Once we remove the needle, we tunnel the lead under your skin and connect the implantable pulse generator (IPG). You can see nothing from the outside. We implant the IPG under the skin above your buttock.

Depending on how you feel immediately after your procedure, we may:

• give you programmes to use on the day; or

• ask you to return to the Pain Clinic a few days later for ‘programming’.

You need to make an appointment with your GP practice nurse after your procedure. They can check your wounds and remove any sutures (stitches).

What are the risks or complications of a SCS?

As with any surgery there are risks, which your pain consultant will discuss with you.

• We may need to stop your procedure.

• A dural puncture can cause a severe headache. You may need treatment with a spinal injection if the headache does not improve within days.

• Bleeding, which may lead to bruising, and in rare cases further surgery.

• Less than 5 in 100 people will develop an infection. If this happens, we may need to remove the whole system.

• A painful IPG site, but this usually resolves with time. If this is severe, we may advise further surgery or the removal of the system.

• The leads may move or not work. You may need another operation to correct this.

• Unpleasant stimulation, which may not respond to stimulation adjustment. Treatment may need to stop.

• Stimulation felt outside of the painful area is common. However, this is only a problem if severe (see above).

• Failure to capture the area of pain, or you have no pain relief. This may lead to surgery to move the leads to another site or remove the system.

• An allergic reaction may lead to the removal of the system.

• Pain relief may decrease over time.

• Nerve damage leading to nerve pain, numbness, and weakness. This may be temporary or permanent.

• Paralysis is extremely rare (2 in 1 million patients).

Will I be totally pain free with SCS?

How much pain relief is achieved with SCS varies between patients, this is the reason for the trial.

Most people find this therapy helps the chronic pain they have suffered with for many years. If successful, your pain could reduce by half.

In time it may mean that we can reduce your pain medications. Always check with your pain consultant or other relevant healthcare professional before changing the dosage of your medications.

What if I need to cancel / change my appointment?

If you cannot come to your appointment, please phone the Pain Clinic. Please give us at least 48 hours notice, so we can offer your appointment to another patient. If you need to cancel or change your appointment more than once, we will not be able to offer you a further appointment.

We will return your referral to your GP if you do not come to your appointment and do not cancel it beforehand. If you need to be referred again, please speak to your GP.

Further information

If you have any concerns or questions, please phone the Pain Clinic.

Kent Centre for Pain Medicine and Neuromodulation (direct lines)

• Kent and Canterbury Hospital, Canterbury
  Telephone: 01227 783049

• Queen Elizabeth the Queen Mother Hospital, Margate
  Telephone: 01843 235094

• William Harvey Hospital, Ashford
  Telephone: 01233 616691

Useful information

• British Pain Society. Stimulating the spinal cord to help with pain: Information for patients. April 2009.

• East Kent Hospitals. Chronic pain patient information.

[Websites last accessed 10 July 2026]

References

• British Pain Society. Stimulating the spinal cord to help with pain: Information for patients. April 2009.

• National Institute for Health and Care Excellence (NICE). Spinal cord stimulation for chronic pain of neuropathic or ischaemic origin. Technology appraisal guidance TA159; published 22 October 2008.

[Websites last accessed 10 July 2026]

Ask 3 Questions

There may be choices to make about your healthcare. Before making any decisions, make sure you get the answers to these three questions:

• What are my choices?

• What is good and bad about each choice?

• How do I get support to help me make a decision that is right for me?

Your healthcare team needs you to tell them what is important to you. It’s all about shared decision making.

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• Patient Voice Team
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