Spinal Cord Stimulation (SCS)

What Clinical Trials Have Reported

Clinical trials vs. real-world practice: The results below come from clinical trials with strict patient selection criteria. In everyday clinical practice, patients are more diverse, and outcomes may differ. Think of clinical trial results as performance under the most favorable conditions.

Key Studies

Historically, SCS was studied mainly in patients who had undergone back surgery but continued to experience pain ("failed back surgery syndrome"). More recent research has also examined SCS in patients with chronic low back pain who have not had prior surgery.

A representative clinical trial (Al-Kaisy et al., 2022; 159 patients) reported that among patients with chronic low back pain and no prior surgery, a significantly greater proportion in the SCS group achieved meaningful pain reduction compared to those receiving conventional medical management alone. Several other trials have reported similar findings (Kapural et al., 2015; Eldabe et al., 2020).

However: These results come from patients who met strict eligibility criteria. Outcomes in a general clinic setting may differ. Also, many SCS clinical trials are funded by device manufacturers.

When SCS Does Not Help

• Even in clinical trials, 10–20% of patients did not achieve meaningful improvement
• The trial stimulation period may not produce sufficient relief — in that case, other treatments are explored
• Even when SCS helps, it does not eliminate pain entirely — it is a treatment that aims to reduce pain, not cure it