Spinal Cord Stimulator Trial: What You Need to Know

Unlike other chronic pain treatment options or surgery, with a spinal cord stimulator you get to try it first to see if it will help relieve your pain before you decide to move forward with the implant. For many people, the 1-week 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 like medications, injections, or surgery.

There’s a lot to think about when deciding to try a spinal cord stimulator. 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! Trying a spinal cord stimulator first for a week, 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’ workers’ compensation covers trying a spinal cord stimulator. Also, trying a spinal cord stimulator is a covered option 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 pain management provider. Find more information about insurance and spinal cord stimulator costs here.

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

You get to “test drive” a spinal cord stimulator to see if it can effectively manage your pain for 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 your 1-week trial, you’ll have the chance to experience the same pain-relieving therapy as the implant, but with a temporary external device. The trial procedure is quick, simple, and outpatient. The trial procedure typically takes about 30-60 minutes and it’s usually performed in your pain management doctor’s office.

Your doctor will place two thin flexible wires, called leads, in your back that deliver the therapy. Placing the leads doesn’t require any incisions and is very similar to an epidural injection. Then the leads are connected to the temporary trial device that’s taped to your back and can be easily covered 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.

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 pain management doctor will numb the area for comfort however you may have slight 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 their trial.

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

Because the temporary device has an external battery, there are a few precautions you may need to take. Your pain management 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 external trial battery wet (don’t swim or shower)

You and your pain management 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 week is a time for you to evaluate your pain relief, improvement with your daily activities, and to see if a spinal cord stimulator 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 percentage 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 week 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 tasks more easily.

To help evaluate your spinal cord stimulator trial, we recommend you track improvements 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 a spinal cord stimulator is the right treatment option for you, it’s important to consider if the pain relief you experienced during your trial week, both while active and resting, will translate into long-term improvement in your overall quality of life.

You and your pain management 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 spinal cord stimulator working during the trial?

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

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

However, HFX^TM offered by Nevro blocks pain signals at the source without a tingling sensation; allowing you just to feel relief. Watch this short video to learn more about how HFX relieves chronic pain:

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.

Getting a spinal cord stimulator doesn’t involve a major surgery and it’s typically safer than spine surgeries used to address chronic pain^1-5. The external trial device is very easy to remove and often takes less than a minute.

The safety of newer spinal cord stimulators like HFX has been thoroughly studied. HFX has a very similar safety profile to other spinal cord stimulators 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 external trial device delivers the same pain-relieving therapy you’ll experience with the implant, making your trial the best guide to how much pain relief you’ll experience with the implant.

Hear firsthand from HFX patient Rod about his experience:

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

It’s important to know that while all spinal cord stimulators deliver therapy to relieve chronic pain, not all spinal cord stimulators can provide the same amount of pain relief or offer the same benefits. HFX is the most advanced spinal cord stimulator available and offers unique benefits that are not offered with traditional spinal cord stimulators:

• HFX provides superior back and leg pain relief¹ – The high frequency therapy, only offered by HFX, uses 10,000 Hz to deliver pain relief. High frequency therapy is clinically proven to deliver superior back and leg pain relief and is designed to treat chronic pain at the source. A large clinical study found that high frequency therapy, only offered by HFX, provides significantly better and longer-lasting back and leg pain relief than low frequency traditional spinal cord stimulators.
• Dedicated long-term support – You’ll have a local Nevro Care Team and a dedicated HFX Coach™ who will be there to provide long-term support whenever you need it.
• Pain relief without tingling  – HFX blocks pain signals without a tingling sensation, letting you just feel relief. Traditional spinal cord stimulators use a tingling sensation to mask pain, which can be uncomfortable
• Longer battery life – The HFX battery is designed to last 10 years, compared to only 2-5 years for non-rechargeable spinal cord stimulators.⁷ This means with HFX you’ll have fewer replacement procedures and insurance requests to go through.
• Full-body MRI access‡– With HFX, you can safely have a full-body MRI scan so you can receive the care you need.  Not all spinal cord stimulators have the same MRI compatibility, you can learn more about the differences here.
• 24-hour pain relief – HFX offers programs you can drive and sleep with, so you can get continuous pain relief day and night.

You can learn more about how HFX is the most advanced option here.

Find out if HFX could be right for your chronic pain

If you’re considering trying a spinal cord stimulator to relieve your pain, the first step is to take a short assessment today to see if you qualify for the most advanced option available – HFX. In the end, you can request a call from an HFX Coach who will answer any questions you have and help you find an HFX doctor in your area. HFX doctors are pain management specialists who have been trained in the minimally invasive procedure to get HFX and are experienced with HFX. They are available nationwide.

If you’re currently exploring spinal cord stimulation with your pain management doctor, at your next appointment we recommend having an informed conversation with your doctor and mentioning that you’re interested in HFX offered by Nevro. Your healthcare is a partnership with your doctor and your doctor wants to know what treatment options you’re interested in.

Sources

^‡Within conditional parameters. Refer to Senza MRI Guidelines for detailed information on MRI safety and conditions.

¹Kapural, L., et al. (2016). 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, 79(5), 667–677.

²Stauss, T., et al. (2019). A multicenter real-world review of 10 kHz SCS outcomes for treatment of chronic trunk and/or limb pain. Annals of Clinical and Translational Neurology, 6(3), 496–507.

³Mirza, S., et al. (2007). Systematic review of randomized trials comparing lumbar fusion surgery to nonoperative care for treatment of chronic back pain. Spine, 32(7), 816–823.

⁴Smith, J., et al. (2010). Complication rates of three common spine procedures and rates of thromboembolism following spine surgery based on 108,419 procedures. Spine, 35(24), 2140–2149.

⁵Deyo, R. (2010). Trends, major medical complications, and charges associated with surgery for lumbar spinal stenosis in older adults. JAMA: The Journal of the American Medical Association, 303(13), 1259.

⁶Kapural, L., et al. (2015). Novel 10-KHz high-frequency therapy (HF10 therapy) is superior to traditional low-frequency spinal cord stimulation for the treatment of chronic back and Leg Pain: The SENZA-RCT randomized controlled trial. Anesthesiology, 123(4), 851–860.

⁷Senza Summary of Safety and Effectiveness Data (SSED). Published May 8, 2015.