Early Signs of Degenerative Disc Disease
Back pain that comes and goes? Struggling to sit or bend without discomfort? Don’t chalk it up to aging — it could be early disc degeneration. Learn the signs before it gets worse.
Don't Let Failed Back Surgery Haunt You: A Guide to Spinal Cord Stimulation
Back surgery is supposed to close a painful chapter, so when pain lingers or returns, it feels like an unfair plot twist.
Unfortunately, that narrative is all too common after back surgery. For various reasons, failed back surgery syndrome (FBSS) can haunt people for months or years.
At SamWell Institute for Pain Management, Jay M. Shah, MD, and Kevin Ko, MD, help patients navigate pain after spine surgery and decide when advanced options — including spinal cord stimulation — make sense.
What we mean by failed back surgery syndrome
Failed back surgery syndrome isn’t a judgment on your operation. It simply means you still have significant pain after one or more spine procedures. Sadly, up to 40% of patients experience FBSS.
The discomfort can be constant or flare with activity and often shows up as low back pain, leg pain, burning or electric shock- like sensations, numbness, or weakness.
Why it happens varies: Epidural scar tissue can tether or irritate nerves, a disc can re-herniate, adjacent segments can break down, or the original pain generator (for example, facet or sacroiliac joints) wasn’t the primary culprit. Sometimes the nervous system itself becomes sensitized, amplifying pain signals even after the structural issue has been addressed.
When spinal cord stimulation helps
Spinal cord stimulation (SCS) is a form of neuromodulation. We place thin leads in the epidural space near your spinal cord; a small pulse generator sends gentle electrical signals that modulate how pain messages are processed before they reach the brain.
Many patients feel a significant reduction in pain intensity and frequency, better sleep, improved function, and less reliance on pain medication. The settings are programmable to target your individual pain pattern.
SCS is most helpful when neuropathic symptoms dominate — think shooting, burning, or electric leg pain after surgery — and when imaging doesn’t point to a clear mechanical problem that needs another operation. If ongoing compression, infection, or unstable hardware is present, we address those issues first.
How perfect timing and a trial reduce guesswork
No one should commit to an implant without proof that it helps. That’s why SCS starts with a trial.
After a careful evaluation, we place trial leads through the skin under X-ray guidance and connect them to an external battery. You go home for several days and live your life — walking, sitting, sleeping — while we fine-tune settings.
If you experience about 50% or more pain relief, plus better function, we can discuss a long-term implant. If not, we simply remove the trial leads and pivot to other strategies. The trial gives clarity and control, and it’s fully reversible.
Why SCS can succeed when other treatments fall short
Medications, injections, and repeat surgeries all have a place, but they don’t always change how the nervous system processes pain. SCS targets the signaling itself — calming overactive pathways, which can reduce the intensity of pain messages your brain perceives.
Think of it as turning down the volume on a channel that’s been stuck on loud for too long. That’s why SCS can help even when imaging looks “okay” but pain remains real and disruptive.
What to expect from the SCS process
We begin with a thorough review of your history, prior imaging, and treatments, and we screen for red flags that point toward a different solution.
If you’re a candidate, the trial is an outpatient procedure with light sedation. Should you move forward after a successful trial, the permanent system is placed under the skin during a minimally invasive outpatient surgery.
Batteries can be rechargeable or not, and the system is adjustable over time as your needs change. As with any procedure, risks exist — infection, lead migration, or inadequate relief — but careful technique and follow-up reduce these risks, and the device is removable if necessary.
Who is a good candidate — and who is not
SCS may be appropriate if you’ve had spine surgery and continue to struggle with neuropathic leg pain or combined back and leg pain despite medications, physical therapy, and injections.
It’s less likely to help if your primary problem is mechanical instability that needs surgical correction, if there’s an untreated infection, or if unmanaged health or psychological factors would limit your ability to benefit from the therapy.
Our role in your recovery
At SamWell, we don’t push a single solution. We build a plan. That can include targeted injections, physical therapy to restore strength and mobility, medication optimization, and — when appropriate — a spinal cord stimulation trial. Dr. Shah and Dr. Ko stay closely involved, adjusting settings, tracking outcomes, and helping you re-engage with the activities that matter most.
Ready to explore whether spinal cord stimulation could finally turn the page on postsurgical pain? Call SamWell Institute for Pain Management in Colonia, Livingston, or Englewood, New Jersey, or request an appointment online to schedule a consultation.
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