Spinal Cord Stimulation (SCS)

Thin leads are placed in the epidural space, along the spinal cord, connected to a small implanted pulse generator that delivers mild electrical signals. Those signals modulate how pain is transmitted before it reaches the brain, and modern systems can do this with or without a perceptible tingling sensation, depending on the programming used.

As with other neuromodulation options, treatment starts with a trial: temporary leads are placed for roughly a week so the patient and Dr. Foster can evaluate how much the device actually reduces pain and improves function in daily life, before committing to a permanent implant.

By modulating pain signaling at the spinal cord — before it reaches the brain — SCS interrupts the pain pathway broadly across the region covered by the leads, which is why it's well suited to more diffuse pain, such as pain affecting a whole leg or a broader area, rather than a single focal nerve. Its strongest evidence base is specifically in failed back surgery syndrome, though it's also used for CRPS and other refractory neuropathic pain conditions.

Because the system is programmable, settings can be adjusted after implantation as a patient's pain pattern or response changes — and because nothing is destroyed or removed, the device itself can ultimately be removed if it's no longer needed or effective.

SCS is most often discussed for low back and leg pain, but leads can also be placed at the cervical level to treat chronic neck pain and upper extremity pain — including failed neck surgery that hasn't responded to less invasive care.

The underlying mechanism is identical to lumbar placement — interrupting pain signals before they reach the brain — but the anatomy calls for real technical adjustments. The cervical epidural space is narrower and the spinal cord sits closer to the lamina at these levels, so lead placement demands more precision, and access is typically gained from a lower entry point, with the leads advanced up to the cervical region under careful imaging guidance to keep an adequate safety margin from the cord. As with lumbar and thoracic placement, a trial period with temporary leads comes first to confirm meaningful relief before permanent implantation.