In brief
- A trial is a temporary, five-to-seven-day period that allows you to experience the relief of neurostimulation before committing to a permanent implant.
- Hold NSAIDs for 24 hours, fast for six hours, and bring a driver.
- Keep the exit site dry, keep lifting light, and log your pain each day.
- Return in five to seven days for lead removal and to discuss the results.
Understanding your diagnosis
When conservative treatments or surgeries have not provided adequate relief for chronic nerve pain, spinal cord stimulation (SCS), peripheral nerve stimulation (PNS), or dorsal root ganglion (DRG) stimulation may be the next step. These therapies work by managing pain signals before they reach the brain.
The treatment
A trial is a temporary, five-to-seven-day period that allows you to experience the relief of neurostimulation before committing to a permanent implant. During the procedure, thin, flexible leads are placed in the epidural space near the spine. These are connected to an external power source you wear on a belt, allowing you to evaluate the therapy during your normal daily activities.
Our approach
Our independent status ensures the success of the trial is measured solely by your personal experience. Dr. Pugh uses live X-ray (fluoroscopy) to ensure precise lead placement tailored to your specific pain pattern.
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 safety and positioning.
- Local numbing and mild sedation are used for your comfort.
- The procedure typically takes 30 to 45 minutes.
- You will return home the same day with the temporary system in place.
Benefits
- Informed decision making: experience the therapeutic effects firsthand before committing to a permanent solution.
- Functional assessment: evaluate real-world improvements in walking, sleeping, and daily tasks.
- Evidence-based alternative: a powerful option to reduce reliance on long-term oral medications.
Recovery
- Activity restrictions: avoid twisting, overhead reaching, or lifting over 5 pounds to keep the temporary leads in place.
- Site care: keep the exit site dry; sponge baths only until lead removal.
- Immediate activity: most patients can resume light activity the next day if movement restrictions are followed.
- Follow-up: return in 5 to 7 days for lead removal and to discuss clinical results.
Afterward: what to expect
- Tracking. Monitor pain levels during the five-to-seven-day evaluation period. Complete the required online form to report your pain relief each day, and keep a daily log of pain scores and functional improvements for discussion with the clinical team.
- Soreness. Expect mild soreness at the insertion site. Use ice packs (20 minutes on, 20 off) and resume baseline medications, including NSAIDs and aspirin, after the procedure.
Activity
Wound care
Your procedure in one paragraph
You have undergone a neuromodulation trial placement, a temporary clinical evaluation designed to determine if neurostimulation effectively manages your chronic pain. Depending on your specific diagnosis, a tiny, thread-like lead was placed under live imaging near your spinal cord (SCS), dorsal root ganglion (DRG), or a targeted peripheral nerve (PNS). This lead is connected to a small external controller, allowing you to evaluate how well the therapy interrupts your pain signals during daily activities before deciding on a permanent system.
Follow-up schedule
- 1
1 week
Lead removal and a formal functional assessment of how well the trial worked.
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.