In brief
- The permanent implant provides consistent, long-term relief and improved daily function, with the whole system under the skin.
- Rest for the first 24 to 48 hours; light activity within days.
- Avoid heavy lifting over 10 pounds, twisting, or reaching for about six weeks to ensure proper healing.
- Return in 14 days for an incision check and device programming.
Understanding your diagnosis
If your clinical evaluation (trial) was successful, it confirmed that neurostimulation effectively manages your chronic pain. The permanent implant provides consistent, long-term relief and improved daily function by addressing specific nerve pain patterns in the back and legs (SCS) or localized areas like the foot, knee, or groin (DRG).
The treatment
The permanent implant involves placing the leads and a small, rechargeable or non-rechargeable battery, the implantable pulse generator (IPG), entirely under the skin. Unlike the trial, there are no external wires or exit sites. This system is designed to provide seamless pain management that integrates into your lifestyle.
Our approach
Dr. Pugh uses live X-ray (fluoroscopy) to secure the permanent leads with sub-millimeter accuracy. Whether you receive SCS or DRG stimulation, the system is programmed to your exact needs.
Before your procedure
For your safety, certain medications must be held before your procedure to minimize the risk of bleeding, following American Society of Regional Anesthesia guidelines. This procedure requires the 24-hour NSAID hold.
| Medication type | Examples | Required hold |
|---|---|---|
| NSAIDs | Ibuprofen, Motrin, Aleve, naproxen, meloxicam | 24 hours |
| Salicylates | Aspirin, all doses | 24 hours |
| Antiplatelets | Plavix (clopidogrel), Brilinta | 7 days |
| Antiplatelets | Effient (prasugrel) | 10 days |
| Anticoagulants | Eliquis, Xarelto, Savaysa, Pradaxa | 5 days |
| Vitamin K antagonist | Coumadin, warfarin | 5 days (INR below 1.5) |
Restarting
Most medications can be restarted 24 hours after the procedure. NSAIDs and aspirin may be resumed immediately.
Fasting, sedation, and your ride home
- If you are receiving sedation, nothing to eat or drink for six hours before your appointment. Essential morning medications may be taken with a small sip of water only.
- We offer light or deep sedation. The level is decided by the physician and anesthesia team based on the procedure and clinical need.
- Any patient receiving sedation must be accompanied by a responsible adult driver to take them home.
Where to go
Procedures are performed at one of three facilities: our clinic at 1925 Hospital Place, ACOM at 6449 Central Park Blvd, or Hendrick South at 6399 Directors Pkwy, Suite 100. Your appointment paperwork tells you which one. Please arrive early for registration and pre-procedure preparation.
Procedure day
- Performed under live X-ray for exact placement and safety.
- Sedation is provided for a comfortable experience.
- The procedure typically lasts about 60 to 90 minutes.
- This is an outpatient procedure; you will return home the same day.
Benefits
- Long-term consistency: reliable relief for chronic nerve pain without daily medications.
- Discreet technology: the entire system is internal and can be controlled with a handheld programmer or smartphone.
- Clinically proven: a sustainable alternative for patients who have not responded to traditional surgery or injections.
Recovery
- Initial activity: prioritize rest for 24 to 48 hours; light activity within days.
- Movement restrictions: avoid heavy lifting (over 10 pounds), twisting, or reaching for about six weeks to ensure proper healing.
- Wound care: keep incision sites clean and dry; instructions for sutures or glue will be given at discharge.
- Follow-up: return in 14 days for an incision check and device programming.
Afterward: what to expect
- Incision soreness. It is normal to feel localized surgical soreness or a bruised sensation around the battery pocket and lead insertion sites for several days.
- Management. Use ice packs over the incisions (20 minutes on, 20 off) and resume your baseline medications. You may resume NSAIDs and aspirin immediately after the procedure.
Activity
Wound care
Your procedure in one paragraph
You have undergone a permanent neuromodulation implant procedure, following your successful clinical evaluation. Depending on your specific nerve pain pattern, a permanent spinal cord stimulator (SCS), dorsal root ganglion (DRG) stimulator, or peripheral nerve stimulator (PNS) system has been placed entirely under your skin. We have positioned the permanent leads and secured the internal implantable pulse generator (IPG) battery to provide you with consistent, long-term relief without external wires.
Follow-up schedule
- 1
2 weeks
Postoperative surgical evaluation, incision check, and device programming.
- 2
2 to 3 months
Formal functional assessment to evaluate device performance and track long-term mobility milestones.
Call us right away if you notice
- New or worsening leg weakness, numbness, or foot drop
- Sudden loss of bowel or bladder control
- Fever above 101.5°F, chills, or drainage at the site
- A severe headache that worsens when sitting or standing
This guide is the same information as the printed handout from Abilene Pain. It is general information and does not replace the instructions your care team gives you at your visit. Your care team: Nicolas Pugh, MD · Adrianne Anders, NP · Ted Chaka, PA.