By the Pain Management Team at Performance Pain and Sports Medicine
Suzanne Manzi, MD
Updated April 2026
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Spinal cord stimulation is an advanced, minimally invasive treatment for chronic pain that has not responded to more conservative therapies. The procedure uses a small implantable device to deliver targeted electrical pulses to the spinal cord, changing the way the brain processes pain signals.
At Performance Pain and Sports Medicine in Baytown, spinal cord stimulation is offered as part of a comprehensive approach to treating persistent nerve pain, failed back surgery syndrome, and other chronic pain conditions. The Baytown office is located on West Baker Road just north of I-10, serving the men and women who keep the Houston Ship Channel running — refinery operators, petrochemical workers, longshoremen, pipefitters, welders, and instrument techs — along with their families across East Harris and Chambers Counties.
What makes spinal cord stimulation unique among pain treatments is the trial period. Before committing to a permanent implant, patients wear a temporary system for several days to confirm it provides meaningful relief. This “try before you commit” approach gives the patient and their physician the information needed to make a confident decision about long-term care.
If chronic pain has limited your ability to work, fish, or enjoy time with your family, spinal cord stimulation may offer a path forward. The sections below cover how the procedure works, who benefits most, and what to expect at every stage.
What Is Spinal Cord Stimulation?
Spinal cord stimulation (SCS) is a form of neuromodulation, a category of treatments that work by altering pain signals before they reach the brain. A small, implantable pulse generator is placed near the spine. Thin, flexible wires called leads deliver targeted electrical pulses to specific areas of the spinal cord.
These electrical pulses interrupt or modify pain signals traveling from the affected nerves to the brain. Rather than masking pain with medication, SCS changes the way the nervous system communicates pain information. Many patients describe the sensation as a mild tingling, though newer systems can provide relief without any sensation at all.
How SCS Technology Has Evolved
Traditional spinal cord stimulators deliver low-frequency electrical pulses that create a tingling sensation in place of pain. While effective for many patients, newer options have expanded who can benefit from this therapy.
High-frequency stimulation delivers pulses at 10,000 Hz, providing pain relief without the tingling sensation. A landmark clinical trial published in Pain found that high-frequency therapy produced significantly higher response rates for both back and leg pain compared to traditional stimulation at 12 and 24 months (Kapural et al., Pain, 2015; Kapural et al., Neurosurgery, 2016).
Burst stimulation mimics natural nerve firing patterns and may be preferred for certain types of pain.
Closed-loop systems automatically adjust stimulation based on the body’s signals, maintaining consistent pain relief as the patient moves throughout the day.
All electrode placements are performed under fluoroscopy guidance for precision.
Conditions Treated with Spinal Cord Stimulation in Baytown
Spinal cord stimulation is most effective for chronic neuropathic pain, the type of pain caused by damaged or misfiring nerves. At the Baytown office, patients with several conditions that may respond well to SCS therapy are evaluated by Dr. Suzanne Manzi and the care team. The patient population reflects Baytown’s industrial economy: refinery and petrochemical operators with chronic post-surgical back pain and FBSS, pipefitters and welders with chronic cervical radiculopathy, longshoremen with persistent CRPS after crush injuries, and a growing population of older adults managing painful diabetic neuropathy.
Failed back surgery syndrome (FBSS) is one of the most common reasons patients consider spinal cord stimulation. Patients who have had one or more spinal surgeries and continue to experience persistent chronic back pain or leg pain may find that SCS provides the relief additional surgery cannot. The PROCESS trial demonstrated that SCS produced significantly greater pain relief than conventional medical management alone in FBSS patients, with benefits sustained at 24 months (Kumar et al., Pain, 2007; Kumar et al., Neurosurgery, 2008).
Complex regional pain syndrome (CRPS) causes severe, burning pain that often affects the arms or legs after an injury or surgery — including the kind of crush, pinch, and degloving injuries that occur in industrial trades. Research published in the New England Journal of Medicine confirmed that SCS combined with physical therapy reduced pain significantly more than physical therapy alone in CRPS patients (Kemler et al., NEJM, 2000).
Painful diabetic neuropathy is a newer indication for spinal cord stimulation. A randomized trial published in JAMA Neurology found that 79% of patients treated with high-frequency SCS achieved 50% or greater pain relief at six months (Petersen et al., JAMA Neurology, 2021).
Other conditions that may benefit from SCS include:
- Chronic radiculopathy (nerve root pain radiating into the arms or legs)
- Persistent neuropathic pain after work-related injury
- Chronic pain that has not responded to medications, injections, or physical therapy
Patients experiencing chronic nerve pain or persistent pain after back surgery can consult Dr. Manzi to determine whether spinal cord stimulation is appropriate. For an overview of how neuropathic pain conditions are approached at PPSM, visit the nerve pain treatment page.
The SCS Trial Period: What to Expect Before You Commit
One of the biggest advantages of spinal cord stimulation over other pain procedures is the trial period. Before committing to a permanent implant, patients test the system for several days to confirm it works for their specific pain pattern.
How the Trial Works
During the trial procedure, thin, flexible leads are placed near the spinal cord using fluoroscopy guidance to ensure precise positioning. The leads connect to a small external generator that the patient wears on a belt or clips to their clothing. The entire placement takes approximately 30 to 60 minutes and is performed under local anesthesia.
What to Expect During the Trial
- The trial typically lasts 5 to 8 days
- Patients go home the same day and resume most daily activities
- Stimulation intensity is controlled with a handheld remote
- Patients track their pain levels, sleep quality, and ability to perform activities throughout the trial
- The care team checks in during the trial to adjust settings as needed
What Determines a Successful Trial
Clinical guidelines from the American Society of Regional Anesthesia (ASRA), the European Society of Regional Anaesthesia (ESRA), and the North American Neuromodulation Society (NANS) recommend that patients achieve at least 50% pain reduction with meaningful improvement in daily function during the trial to be considered candidates for permanent implantation (Shanthanna et al., Regional Anesthesia & Pain Medicine, 2023).
This threshold exists to protect patients. If the trial does not meet that standard, the team does not proceed with a permanent implant. The leads are simply removed in a brief office visit, and other treatment options are explored. Not every pain treatment offers this kind of confirmation before commitment. The trial period is one of the primary reasons spinal cord stimulation is recommended for patients who qualify.
The Permanent SCS Implant Procedure
If the trial confirms meaningful pain relief, the next step is the permanent spinal cord stimulator implant. This is a minimally invasive, outpatient procedure that typically takes one to two hours.
Step-by-Step Process
- Preparation. The patient receives sedation or light general anesthesia. The procedure area is cleaned and numbed.
- Lead placement. Using fluoroscopy guidance, the permanent leads are positioned along the spinal cord at the location that provided the best relief during the trial.
- Generator implantation. A small pulse generator is placed beneath the skin, typically in the upper buttock area or lower back, through a small incision. A thin wire is tunneled under the skin to connect the leads to the generator.
- Testing. The system is tested before the patient leaves to confirm proper function.
Patients go home the same day. Most are up and walking within hours of the procedure.
Device Options
Modern spinal cord stimulators come in rechargeable and non-rechargeable models. Rechargeable devices offer a smaller generator and longer battery life but require periodic charging at home. Non-rechargeable devices need no maintenance but are replaced surgically when the battery depletes, typically after several years.
Today’s devices are also designed with MRI compatibility in mind. The FDA has cleared spinal cord stimulator systems that allow patients to undergo MRI scans safely, which is an important consideration given that an estimated 82 to 84 percent of SCS patients will need an MRI within five years of implant (Desai et al., Spine, 2015).
The treating physician will discuss which device options best fit each patient’s pain pattern, lifestyle, and long-term needs during the consultation.
Benefits of Spinal Cord Stimulation
Research consistently shows that spinal cord stimulation provides meaningful, lasting pain relief for appropriately selected patients. A 2024 network meta-analysis published in JAMA Network Open, which synthesized data from multiple randomized controlled trials, confirmed that SCS therapies demonstrate superiority over conventional medical management for chronic back and leg pain across multiple conditions (Huygen et al., JAMA Network Open, 2024).
Key benefits of SCS include:
- Significant pain reduction. Clinical trials consistently use 50% or greater pain relief as the success benchmark. The majority of patients who complete a successful trial period go on to achieve sustained pain relief with permanent implantation.
- Reduced reliance on pain medications. Many patients are able to decrease their use of oral pain medications, including opioids, after successful SCS implantation.
- Improved daily function. Patients frequently report improvements in walking, sleeping, and returning to work or recreational activities.
- Reversible and adjustable. Unlike surgical procedures that permanently alter anatomy, a spinal cord stimulator can be reprogrammed, adjusted, or removed if needs change.
- Drug-free pain relief. SCS delivers pain relief through electrical stimulation rather than systemic medication, avoiding common side effects of long-term drug therapy.
- Trial before commitment. Patients confirm the therapy works for them before proceeding to permanent implantation.
Individual results vary based on the patient’s specific condition, pain duration, and overall health. The treating physician will discuss realistic expectations during the consultation.
Am I a Candidate for Spinal Cord Stimulation?
Spinal cord stimulation is not a first-line treatment. It is typically considered after more conservative therapies have been tried without adequate relief. Clinical guidelines from ASRA, ESRA, and NANS outline specific criteria that help physicians identify patients most likely to benefit from this therapy (Shanthanna et al., Regional Anesthesia & Pain Medicine, 2023).
A patient may be a candidate for SCS if they have:
- Chronic neuropathic pain lasting six months or longer
- Pain that has not responded adequately to physical therapy, medications, or injections
- A diagnosis of failed back surgery syndrome, CRPS, chronic radiculopathy, or painful diabetic neuropathy
- Realistic expectations about pain reduction rather than complete pain elimination
- No untreated psychological conditions that could affect response to therapy
The Role of Psychological Evaluation
Most SCS programs include a psychological screening before proceeding to a trial. This is not a judgment of whether pain is “real.” It is a standard step that helps identify factors such as untreated depression or anxiety that could reduce the likelihood of a successful outcome. Addressing these factors before the trial improves the chances of long-term success.
Candidacy is always determined on an individual basis. During the consultation, the physician reviews imaging, medical history, and prior treatments to determine whether SCS is the right next step for each patient’s care.
Recovery and What to Expect After Spinal Cord Stimulation
Recovery from spinal cord stimulation depends on whether the patient is in the trial phase or has received a permanent implant.
After the Trial
The trial leads are placed through a minimally invasive approach and removed in a brief office visit once the trial period ends. Most patients resume normal daily activities within a day or two. There are no long-term restrictions from the trial itself.
After Permanent Implantation
Week 1 to 2. Limit bending, twisting, and lifting to allow the incision sites to heal. Light walking is encouraged.
Week 2 to 6. Activity levels are gradually increased as directed by the physician. Heavy lifting and high-impact exercise should be avoided during this period.
Week 6 and beyond. Most patients return to full activity, including exercise and work, by six to eight weeks.
Follow-up visits during the first few months allow the care team to adjust stimulator settings and optimize pain relief. Programming adjustments are a normal part of the process, not a sign that something is wrong.
Long-Term Expectations
Clinical evidence supports sustained pain relief from SCS over time. The PROCESS trial demonstrated that FBSS patients maintained significant improvements in pain, function, and quality of life at 24 months compared to conventional medical management (Kumar et al., Neurosurgery, 2008). However, outcomes can vary, and some patients may require periodic reprogramming or lead revision over the life of the device.
Risks and Safety of Spinal Cord Stimulation
Like any medical procedure, spinal cord stimulation carries potential risks. Understanding these risks is an important part of making an informed decision about care.
Potential complications include:
- Lead migration. The most commonly reported complication. Stimulator leads can shift from their original position, which may reduce pain relief effectiveness. Repositioning is typically a minor procedure.
- Infection. Surgical site infection can occur after implantation. Proper wound care and follow-up visits help reduce this risk.
- Hardware malfunction. Battery depletion, lead fracture, or connection failure may require a revision procedure to replace the affected component.
- Pain at the implant site. Some patients experience discomfort at the generator pocket, particularly in the weeks following surgery. This typically resolves as the area heals.
- Inadequate pain relief. Not all patients experience the same level of benefit. This is one reason the trial period is so important; it helps identify patients who are most likely to respond well before permanent implantation.
A comprehensive review of SCS complications found that overall complication rates range from approximately 32% to 43%, with lead migration being the most frequent issue. The majority of these events are minor and manageable, such as lead repositioning or temporary discomfort, rather than serious adverse outcomes. Modern anchoring techniques have reduced migration rates compared to earlier devices (Hayek et al., Neuromodulation, 2023).
The treating physician will discuss all risks specific to each patient’s health history before any procedure is scheduled.
Why Choose Performance Pain and Sports Medicine for Spinal Cord Stimulation
When patients choose spinal cord stimulation at the Baytown office, they benefit from physician-led care with advanced training in neuromodulation and interventional pain management.
Dr. Suzanne Manzi, MD — Quadruple Board-Certified in Physical Medicine & Rehabilitation, Pain Medicine, Electrodiagnostic Medicine, and Obesity Medicine — is a member of the North American Neuromodulation Society (NANS) and stays current with the latest developments in spinal cord stimulation technology, patient selection, and programming optimization. Her fellowship training in interventional spine and pain management at Michigan State University, combined with her role as teaching faculty at UT Health Houston McGovern Medical School, provides both the clinical depth and academic perspective to guide complex neuromodulation decisions. Dr. Manzi is also a founding member of the Society of Women Innovators in Pain Management. She speaks English and Spanish and treats patients across our Houston, Baytown, and League City offices.
What sets the Baytown practice apart:
- Physician-led care with Dr. Suzanne Manzi, board-certified in interventional pain management and neuromodulation
- Workers’ compensation handling for refinery, petrochemical, Houston Ship Channel, and other industrial workplace injuries
- Coordination with employer medical departments at the ExxonMobil Baytown Complex, Chevron Phillips Cedar Bayou, Covestro, and other industrial employers in the Cedar Crossing Industrial Park area
- Bilingual care (English and Spanish) reflecting the Baytown community
- Dedicated one-on-one consultation time
- Access to both traditional spinal cord stimulation and DRG stimulation to match each patient with the approach best suited to their pain pattern
- Convenient Baytown office on West Baker Road just north of I-10, accessible from Mont Belvieu, Channelview, Highlands, Crosby, La Porte, Anahuac, and Dayton
At PPSM, the right approach to chronic pain starts with a thorough evaluation and an honest conversation about options. When spinal cord stimulation is appropriate, the team guides patients through every step of the process.
Performance Pain and Sports Medicine
Address: 1650 W. Baker Rd., Ste A, Baytown, TX 77521
Cross Streets: West Baker Road near Garth Road, just north of I-10
Parking: On-site parking available
Phone: 346-217-1111
Conveniently located on West Baker Road just north of I-10 and minutes from the ExxonMobil Baytown Complex, the Baytown office serves patients throughout East Harris and Chambers Counties, including Mont Belvieu, Channelview, Highlands, Crosby, La Porte, Anahuac, Beach City, and Dayton.
Frequently Asked Questions About Spinal Cord Stimulation
Is the spinal cord stimulator procedure available in Baytown?
Yes. The spinal cord stimulator (SCS) trial and permanent implant are offered through the Baytown office, performed by Dr. Suzanne Manzi, MD, quadruple board-certified pain physician and member of the North American Neuromodulation Society. The trial procedure can be scheduled in-office; the permanent implant is performed at an affiliated outpatient surgery center in the Houston metro area. We accept workers’ compensation for refinery, petrochemical, and Houston Ship Channel injuries, and we coordinate with employer medical departments at the ExxonMobil Baytown Complex, Chevron Phillips Cedar Bayou, Covestro, and other local industrial employers. Bilingual care is available in English and Spanish. Most insurance plans, Medicare, and workers’ compensation cases cover medically necessary SCS. Call 346-217-1111 or request an appointment online.
How long does a spinal cord stimulator last?
Rechargeable spinal cord stimulators can last 10 years or more before the generator needs replacement. Non-rechargeable devices typically last 3 to 7 years depending on usage settings. Replacing the generator is a minor outpatient procedure that does not require repositioning the leads.
Can you get an MRI with a spinal cord stimulator?
Many modern spinal cord stimulators are designed to be MRI-compatible. Research shows that an estimated 82 to 84 percent of SCS patients will need an MRI within five years of implant, so MRI compatibility is an important factor when selecting a device (Desai et al., Spine, 2015). The treating physician will discuss which MRI-compatible options are available for each patient’s situation.
What is the success rate of spinal cord stimulation?
Clinical trials define success as 50% or greater pain reduction with improved function. A 2024 network meta-analysis confirmed that SCS therapies are superior to conventional medical management for chronic pain across multiple conditions (Huygen et al., JAMA Network Open, 2024). Individual results depend on the patient’s specific diagnosis, pain history, and response during the trial period.
Does insurance cover spinal cord stimulators?
Most major insurance plans, including Medicare, cover spinal cord stimulation when medically necessary. Coverage typically requires documentation of failed conservative treatments and a successful trial period. The team at PPSM can help verify insurance benefits before scheduling. Call the Houston office at 346-217-1111 to discuss coverage before scheduling a consultation.
How long is recovery after a spinal cord stimulator implant?
Most patients return to light activities within one to two weeks and resume full activity by six to eight weeks. The treating physician will provide specific activity guidelines based on each patient’s procedure.
What does spinal cord stimulation feel like?
Traditional SCS systems produce a mild tingling sensation in the area where pain is normally experienced. Newer high-frequency and burst systems can provide pain relief without any noticeable sensation, which many patients prefer.
Schedule Your Spinal Cord Stimulation Consultation in Baytown
If chronic pain has not responded to medications, injections, or physical therapy, spinal cord stimulation may be the next step. Patients are welcome to schedule a consultation at the Baytown office to discuss whether SCS is right for their situation.
During the visit, Dr. Manzi will review imaging, medical history, and prior treatments to determine whether the patient is a candidate for a stimulator trial.
Performance Pain and Sports Medicine
1650 W. Baker Rd., Ste A, Baytown, TX 77521
Phone: 346-217-1111
MEDICAL DISCLAIMER
This article is for educational purposes only and does not replace professional medical advice, diagnosis, or treatment. The information presented reflects an interventional pain management perspective and is intended to support, not substitute, your relationship with a qualified healthcare provider. Individual results vary based on diagnosis, pain duration, overall health, and response to treatment. Some procedures may not be covered by insurance. Treatment outcomes depend on proper patient selection and accurate diagnosis. Always consult a board-certified physician before pursuing any pain management treatment.
Spinal cord stimulation requires a surgical implantation procedure and is typically considered after more conservative treatments have been tried. Not all patients are candidates for this therapy.
Performance Pain and Sports Medicine
Medically reviewed by Suzanne Manzi, MD
Board-Certified in Physical Medicine & Rehabilitation, Pain Medicine, Electrodiagnostic Medicine, and Obesity Medicine
Last reviewed: April 2026
