Recovery after a spinal cord stimulator implant: stage by stage

Hospitals differ in how they run the trial and implant, and the leaflets retrieved show it: the trial may be at home or in hospital, and restrictions vary by a few weeks. The table gives the ranges seen across three NHS leaflets. Your own unit's written plan, and the advice of the pain nurses, replace it.

The restrictions have a purpose: leads can move if the spine is flexed or stretched hard in the early weeks, before scar tissue holds them in place. Following the limits protects the pain relief you are hoping for.

North Bristol advises keeping dressings dry and intact and watching for leakage, redness, swelling, pain or a raised temperature. Leeds asks you to check wounds daily and to contact the pain nurses straight away for redness, pus, excessive swelling or drainage. Dudley expects discomfort for up to six weeks and says pain-relieving medicines are needed in that time, while North Bristol says to keep taking your usual pain medicines for six weeks.

Expect two wounds after the permanent implant: one over the spine and another in the buttock, abdomen or chest wall for the battery. North Bristol puts the infection rate at approximately 5% of cases, which is why daily checks matter.

For the first weeks both North Bristol and Leeds say to avoid raising the arms above the head, bending, twisting and heavy lifting, and to limit long spells of sitting. Leeds also advises log-rolling, turning the whole body as one unit, when changing position in bed. Dudley advises avoiding new exercise and keeping good posture, and gradually increasing activity with help.

North Bristol says not to use power tools or operate equipment while the stimulator is active. Short, regular walks are a reasonable way to keep moving, but anything involving stretching the spine should wait for clearance from your team.

North Bristol says avoid driving for at least two weeks after the implant and not at all while the stimulator is on. Leeds says no driving for at least four weeks after the implant and during the trial, and that you cannot drive with the stimulator on if you are using a tingling programme. GOV.UK says to ask your doctor how an operation affects driving and to tell the DVLA if you are still unable to drive three months after surgery. Your insurer may need to be told.

The leaflets do not give a return-to-work time, because it depends on how physical the job is and on the movement limits above. Ask your pain team for a date for your own role, and ask how to handle seatbelts and airport security with the device.

North Bristol says the system is programmed after the operation, and you control strength with a hand-held programmer. Leeds says initial reviews may be by telephone or video, and face-to-face reprogramming begins after about six weeks once the wounds have healed. Dudley says to inform healthcare providers about the device before any MRI scan or physiotherapy, and North Bristol warns that an MRI can cause harm to you and the generator.

Keep your device identification card with you, and tell dentists, physiotherapists and scan departments about it.

• Fever, neck stiffness or headache, or flu-like symptoms: urgent assessment, A&E if severe (Leeds and North Bristol).

• New weakness or numbness in the arms or legs, difficulty passing urine or loss of bowel control: A&E immediately.

• Increasing severe back or neck pain, or heavy drainage from a wound: contact your pain team urgently.

• Redness, pus or swelling at either wound: contact the pain nurses promptly.