When the stimulator isn't enough

Spinal Cord Stimulator Not Working? Painkillers Aren't the Answer

You were told the stimulator was the next step after surgery didn't solve things. Now it's in, it helps less than you hoped, and you're still taking painkillers to get through the day. If that's you, this was written for you.

A spinal cord stimulator is usually offered when other options have run out, often after back surgery that didn't fix the pain, which is known as failed back surgery syndrome. For some people it works well. For many it helps a little, helps for a while, or doesn't help at all.

A stimulator that falls short is more common than you've been told

The research says so. A 2025 systematic review in the Journal of Pain Research covered 25 studies and about 13,000 people with permanent implants. Depending on the study, between under 2% and 38% of devices were later removed, and not getting enough pain relief was the most common reason. In one of the follow-up studies, just over half of the removals happened within the first year.

If yours isn't delivering, that doesn't make you a difficult patient, and it doesn't mean the pain is "in your head." A device that quiets a signal doesn't always reach what keeps the signal alive.

What years of painkillers really cost

Painkillers have their place, especially during a flare-up. The trouble starts when they become the plan. After months or years, the price is well documented:

• Opioids (tramadol, codeine, morphine, oxycodone, tapentadol): constipation, drowsiness, nausea, dizziness and foggy thinking. The body adapts, so the same dose gives less relief over time. Dependence and withdrawal are real risks, and in some people opioids make the nervous system more sensitive to pain (opioid-induced hyperalgesia).
• Anti-inflammatories (ibuprofen, naproxen, diclofenac): stomach irritation, ulcers and bleeding, strain on the kidneys, and higher blood pressure and cardiovascular risk, especially with long-term or high-dose use.
• Nerve-pain drugs (gabapentin, pregabalin): drowsiness, dizziness, weight gain and swollen legs. Some people become dependent, and combining them with opioids or other sedatives can affect breathing.
• Paracetamol: well tolerated at normal doses, but studies in low back pain have found little benefit over placebo, and too much damages the liver.

Many people end up on two or three of these at once, and the side effects stack. None of this means you should stop what you're taking: several of these drugs, opioids, gabapentin and pregabalin in particular, have to be reduced slowly with the doctor who prescribed them. It simply means you deserve to know what the trade-off is.

Painkillers turn the volume down. They don't ask why it's loud.

A painkiller lowers how loudly you feel the pain. It doesn't change why your nervous system keeps producing it. After surgery, injections and years of pain, many people develop what's called central sensitization: a nervous system that stays on high alert and amplifies signals, sometimes long after the original problem has healed or been operated on. It's also why a stimulator, which works on that same signal, can only do so much.

Medical guidance has been moving the same way. The UK's NICE guideline on chronic primary pain (NG193, 2021) advises against offering opioids, gabapentinoids, paracetamol and anti-inflammatories for that kind of pain, because the evidence of benefit is weak and the harms are real. Pain after surgery isn't always classified as "primary" pain, so ask your doctor how it applies to you. The direction is still clear: long-term medication on its own is no longer seen as a good answer to persistent pain.

A different question: why is your body still protecting you?

Visceral osteopathy starts from another question. Not "where does it hurt?" but "what has your whole body learned to do around this pain?" After a long time in pain, almost everyone guards without realizing it: movement quietly disappears from some areas, tension turns into a habit, and the body stays braced even when there's no longer a reason to. My work is to find those patterns, release them gradually, and help your nervous system stop treating everything as a threat.

It doesn't replace your doctors or your device. It works from an angle that painkillers and stimulators don't reach.

What I can promise, and what I can't

I can't promise this will solve what surgery and a stimulator didn't. Nobody honest can. What I can say is that it works through a different mechanism than anything you've likely tried, and that some people whose pain stayed despite doing everything "right" have found that a different angle made the difference. Medication stays a matter for your doctor.

Tell me your story

You can message me on WhatsApp. A few lines are enough:

• What surgery you had, and when
• When your stimulator was implanted and how much it helps now
• What you take for pain at the moment
• What else you've tried since
• What symptoms you're still living with

With that, I'll tell you straight whether I think this makes sense for your case, or whether you should look elsewhere. No pressure and no promises, just an honest opinion on whether there's something still worth trying.