Spinal cord stimulators (SCS) have become a life-changing solution for many individuals living with chronic pain. These devices, which deliver electrical impulses to the spinal cord to block pain signals, can significantly improve quality of life for those who suffer from conditions like failed back surgery syndrome, complex regional pain syndrome (CRPS), and neuropathic pain. However, as with any medical intervention, there are risks—and one of the most frequently reported complications is overstimulation.
According to Jordan Sudberg, a leading pain management specialist with extensive experience in neuromodulation, understanding and managing spinal cord stimulator overstimulation is critical to ensuring patient safety, comfort, and long-term treatment success. In this post, we explore what overstimulation is, why it occurs, and how patients and clinicians can address it effectively.
What Is Spinal Cord Stimulator Overstimulation?
Overstimulation occurs when the electrical impulses delivered by the spinal cord stimulator are too intense, misaligned, or irritating to surrounding nerves. While the goal of SCS therapy is to provide a soothing tingling sensation known as paresthesia that masks pain signals, overstimulation results in sensations that are often described as:
- Sharp or stabbing
- Electric shock-like
- Muscle twitching or spasms
- Uncomfortable tingling in unintended areas
“Many patients initially mistake overstimulation for normal device function,” explains Jordan Sudberg. “But when those sensations become disruptive or painful, it’s essential to address them quickly. Ignoring these symptoms can lead to reduced therapy compliance or, in some cases, the removal of the device.”
Common Causes of Overstimulation
Jordan Sudberg emphasizes that overstimulation can stem from a variety of factors, including:
1. Lead Migration
One of the most common causes of overstimulation is lead migration. Over time, the implanted leads that deliver electrical impulses can shift from their original position, stimulating unintended nerve pathways.
“Lead migration is something we always monitor closely after implantation,” says Sudberg. “It’s not uncommon, and the good news is that it can often be corrected with reprogramming or minor surgical adjustment.”
2. Improper Programming
Each SCS device must be customized to the patient’s specific anatomy and pain profile. If the programming is not optimized, patients may experience overstimulation either during activity or at rest.
“Device programming is both an art and a science,” says Dr. Sudberg. “We work closely with device reps and the patients to fine-tune the settings so the stimulation is effective but never uncomfortable.”
3. Postural Changes
Because the position of the spine can affect how electrical signals are received, patients often notice changes in stimulation when they bend, twist, or lie down. These postural changes can lead to temporary overstimulation.
“We always educate patients to be aware of how their body position impacts the device,” says Sudberg. “Some patients need different settings for different activities, and modern devices allow for that flexibility.”
How to Address Overstimulation
Fortunately, overstimulation is a treatable and manageable complication. According to Jordan Sudberg, these are the most effective strategies:
1. Reprogramming the Device
In most cases, a simple reprogramming session with a pain management specialist or device technician can resolve the issue. Adjusting amplitude, pulse width, or frequency often makes a significant difference.
“We can usually make the necessary changes non-invasively,” Sudberg says. “It’s quick, painless, and often provides immediate relief.”
2. Patient Education and Communication
Sudberg emphasizes that education is a powerful tool. Patients should understand how to use their remote control to adjust settings and know when to contact their provider.
“Patients need to feel empowered,” he notes. “If something feels off, we want them to reach out—not suffer in silence.”
3. Surgical Revision (if needed)
In rare cases where lead migration is severe or hardware issues are suspected, a surgical revision may be necessary. This is usually a last resort after other interventions have failed.
The Importance of Personalized Care
What sets Jordan Sudberg apart in the field of pain management is his commitment to individualized care. He views each patient not as a diagnosis, but as a partner in their own healing journey.
“Pain is deeply personal, and so is the treatment,” he says. “No two people respond to spinal cord stimulation in exactly the same way. That’s why ongoing communication, follow-up, and personalized adjustments are so critical.”
Conclusion: Living Comfortably with SCS
While spinal cord stimulator overstimulation can be uncomfortable and even alarming, it is highly manageable with the right support. With skilled practitioners like Jordan Sudberg, patients can navigate these challenges confidently, ensuring their device delivers maximum relief with minimal side effects.
“Technology can do amazing things,” says Sudberg. “But it’s our responsibility as physicians to ensure it works for the patient—not the other way around.”
If you or a loved one is using or considering a spinal cord stimulator, make sure you’re working with a provider who understands the nuances of device management and is committed to your long-term success—just like Jordan Sudberg.