Neurostimulation Devices 101: From Spinal Cord Stimulators to HFX Therapy

Chronic pain affects daily life, sleep, mood, and the ability to work or recreate. When conservative care (physical therapy, medications, injections) isn’t enough, neurostimulation devices present another option. This post explains the main types of neurostimulation—spinal cord stimulators (SCS), high-frequency therapy (HFX), burst stimulation, dorsal root ganglion (DRG) stimulation, and peripheral nerve stimulation (PNS)—and what patients should know before pursuing therapy.

What is Neurostimulation?

Neurostimulation uses electrical pulses to modulate nerves involved in pain signaling. By delivering targeted stimulation to the spinal cord or peripheral nerves, these devices can reduce the brain’s perception of pain. Most programs start with a short trial so clinicians and patients can assess real benefit before placing a permanent implant.

Main Types of Neurostimulation

• Traditional (low-frequency) Spinal Cord Stimulation: Dorsal column stimulation that often causes paresthesia overlapping the painful area.
• High-Frequency Stimulation (HFX): High-frequency waveforms that may relieve pain without paresthesia.
• Burst Stimulation: Packs of pulses that mimic natural neuronal firing and may improve both pain and emotional response to pain.
• Dorsal Root Ganglion (DRG) Stimulation: Very focal modulation for localized neuropathic pain.
• Peripheral Nerve Stimulation (PNS): Targets peripheral nerves for pain localized to a nerve distribution.

Trial vs. Permanent Implant

Trials are minimally invasive and last days to two weeks. Success during the trial (commonly ≥50% pain reduction) usually leads to a permanent implant, which includes implanted leads and an internal pulse generator placed under the skin.

Who Is a Candidate?

Good candidates typically have chronic neuropathic or radicular pain refractory to conservative care, stable medical and psychological profiles, and realistic expectations. Specific device choices depend on pain location and patient preference.

Benefits

• Meaningful pain reduction for many patients
• Improved function and activity tolerance
• Potential reduction in opioid use
• Adjustable therapy with ongoing optimization

Risks & Limitations

Risks include infection, lead migration, device malfunction, and variable long-term response. Discuss complications, device maintenance, and expected outcomes with your implanting team.

Recovery & Follow-Up

After implantation expect limited lifting and activity for several weeks, follow-up programming visits, and periodic device checks. Many systems are rechargeable; you’ll learn the recharging routine if applicable.

Measuring Success

Success is measured by pain scores, functional improvements, quality of life, and reduced medication use. Ongoing assessment helps tailor the therapy for each patient.

Choosing Your Team

Choose a multidisciplinary program with experienced implanters, psychological screening, clear trial protocols, and strong follow-up support. Ask about MRI compatibility, warranty, and device replacement policies.

Quick FAQ

• Will I feel the stimulation? Traditional SCS often produces paresthesia; HFX and some burst settings may not.
• Is a successful trial guaranteed long-term? No—trial response is predictive but not guaranteed over years; ongoing care matters.
• Can I get an MRI? Many devices are MRI-conditional—verify your specific model with the clinic.
• Is it reversible? Yes—implants can be removed if necessary.

Conclusion

Neurostimulation offers customizable, reversible options for people with chronic pain who have not found sufficient relief with conservative care. With thoughtful patient selection, a trial period, and an experienced team, many patients regain function and quality of life. If chronic pain is limiting your life, speak with your pain specialist to see whether a neurostimulation trial could fit your care plan.

Disclaimer: This post is for informational purposes only and does not replace medical advice. Talk to your clinician about individual risks and benefits.

Interested in learning whether neurostimulation may help you or your patients? Schedule a consultation with a qualified pain specialist to discuss candidacy, trial options, and the latest device choices.