After Surgery (SCS) — Care Instructions — Timoteo Almeida, MD, PhD
🩹 Post-operative care

After Surgery: Spinal Cord Stimulation

Care instructions for SCS trial and permanent implant

Practical guidance on wound care, activity restrictions, recovery milestones, medication, and when to call your team.

#1

Protect Your Leads While They Scar In

Your top priority in the first weeks is preventing lead movement. Early lead migration is one of the most common reasons patients need reprogramming — and sometimes revision.

No BLT: Bending · Lifting · Twisting
First 0–14 days

What's Normal After Surgery

📋

Expected Symptoms

  • ✓ Soreness and bruising at the back incision and battery pocket (buttock/flank/abdomen)
  • ✓ Mild fatigue — this is your body healing
  • ✓ Temporary changes in stimulation coverage — swelling and healing can change what you feel
  • ✓ Mild swelling or a "full" feeling at the pocket site
Wound care

Incision Care

🩹

Keep Incisions Clean & Dry

During the trial period:

  • ✕ No showering — keep the leads and battery completely dry
  • ✕ No soaking (bath, pool, hot tub) until cleared — at least 2 weeks
  • ✕ Don't apply lotions, ointments, or powders unless instructed
  • ✕ Do not scratch your incision

For permanent implants:

  • → Keep the dressing clean and dry for the first 48 hours
  • → After 48 hours: you may remove the dressing and leave the incision open to air (unless told otherwise)
  • → When showering is allowed: let water run gently over the area — do not scrub — pat dry with a clean towel
  • → Starting 5 days after surgery: wash the incision gently with baby soap and water, rinse well, pat dry
⚠

Watch Closely for Infection

Call your team if you notice any of the following:

  • ⚠ Increasing redness, warmth, swelling, or worsening pain
  • ⚠ Pus-like drainage or bad odor
  • ⚠ Wound opening
  • ⚠ Fever
📅

Staple/suture removal: Commonly around 10–14 days. You will have a post-operative appointment with your neurosurgery team in 1–2 weeks for wound exam and suture removal. Please contact the office to confirm your appointment.

First 4–6 weeks

Activity Restrictions

These restrictions protect your leads while they stabilize in position. Early lead movement can reduce or change stimulation coverage — and is the most common reason patients need reprogramming or revision.

✕ Avoid

  • Bending at the waist (use your knees instead)
  • Twisting (turn your whole body, not your spine)
  • Sudden reaching, stretching, or "jarring" movements
  • Heavy lifting (> 10 lbs)
  • Strenuous exercise until cleared

✓ Do

  • Walk daily as tolerated — increase gradually
  • Keep movements slow and controlled
  • Use your knees when bending down
  • Turn your whole body instead of twisting
🚗

Driving: Do not drive while taking opioid pain medication or if you feel foggy or dizzy. Ask your team when it's okay to resume — timing depends on pain control and recovery.

Your device

Device Use & Programming

⚙

What to Expect

  • → You'll be taught how to use your patient controller and what "safe adjustments" look like
  • → Early on, coverage may change — this is common during healing
  • → Expect follow-up visits for programming optimization (often several visits)
  • → If your system is rechargeable, follow the charging plan you were given
💡

Don't place pressure directly on a healing incision during charging. Your team will show you how to position the charger comfortably.

Medications

Pain Control & Medication

Medication guidance

✓ You may take

Acetaminophen (Tylenol) 500–650 mg every 4–6 hours as needed for pain or headaches. Use prescribed pain medication only as directed.

✕ Do not take without clearance

Aspirin, ibuprofen (Advil), naproxen (Aleve), meloxicam, or any NSAIDs for at least 1 week. No blood thinners (Coumadin/warfarin, Plavix, Eliquis, Xarelto, Brilinta) unless instructed by your neurosurgical team.

💊

Constipation is common — especially with opioids. Stay hydrated, eat fiber, and use stool softener or laxative as your team recommends.

Common questions

Patient FAQs

Why so many movement restrictions?
Because early lead movement can change stimulation coverage or reduce your pain relief. The leads need time to stabilize in position — typically 4–6 weeks. Following the BLT restrictions (no bending, lifting, twisting) gives you the best chance of keeping your leads where they belong.
What if my stimulation suddenly changes or my relief drops?
Healing-related changes in coverage are common and don't necessarily mean something is wrong. That said, if your pain relief is significantly reduced, call your team. Reprogramming can often restore benefit — and if a lead has moved, your team will know what to do.
Do I need a psychological evaluation?
Many best-practice protocols include psychosocial screening as part of neuromodulation care. This isn't a barrier to treatment — it's a standard part of ensuring the best outcomes and supporting you through the process.
!

When to Seek Urgent Care

  • Fever with chills, or worsening incision redness or drainage
  • New leg weakness, new numbness, severe back pain with neurologic symptoms, or loss of bowel/bladder control
  • Severe headache — especially if worse when sitting or standing and better lying down
  • Chest pain, shortness of breath, or fainting