ArticlePain medicine (Malden, Mass.)2021
Treatment Strategies for Generator Pocket Pain.
Article in Pain medicine (Malden, Mass.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- [Peripheral nerve stimulation-A new perspective in surgical pain treatment].Schmerz (Berlin, Germany) · 2026Review
- History of SCS and patient-focused innovations: a manufacturer's perspective on the role of technology.Pain medicine (Malden, Mass.) · 2026Review
- Troubles in the Pocket: Evidence- and Experience-Based Multidisciplinary Expert Consensus Recommendations for Implantable Pulse Generator Placement and Management of Associated Inconveniences.Current pain and headache reports · 2026Article
- Peripheral nerve stimulation - Our experiences with the wireless high-frequency system.Brain & spine · 2026Article
- Spinal Cord Stimulation - Device Revision After Weight Loss in a Patient on Chronic Semaglutide - A Case Report.International medical case reports journal · 2025Article
- Factors in Surgical Placement and System Design to Reduce Pocket Awareness and Optimize the User Experience of Spinal Cord Stimulators - A Comprehensive Review.Journal of pain research · 2025Review
- Device-Related Complications Associated with Cylindrical Lead Spinal Cord Stimulator Implants: A Comprehensive Review.Current pain and headache reports · 2024Review
- Restoring Successful Spinal Cord Stimulation Therapy for a Patient with Severe Pocket Pain Utilizing Nalu Micro-Implantable Pulse Generator.Orthopedic reviews · 2022Review
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Authors and funding
10 authors.
Funding
Abstract
objectiveGenerator site pain is a relatively common phenomenon in patients undergoing spinal cord stimulation (SCS) that complicates management and effective pain relief. This pain may be managed conservatively, with repositioning of the battery and, in some cases, with explant. Here we explore our experience with management of generator site pain ("pocket pain") in a large single-center study.
methodsAll SCS permanent implants and implantable pulse generator (IPG) placements over 9 years were reviewed. Of 785 cases, we identified 43 patients with pocket pain (5.5%). Demographics and treatments of the pocket pain cohort were analyzed.
resultsThe mean age (± SEM) of the pocket pain cohort was 46.86 ± 1.06, and there were 10/33 males/females. Females were overrepresented in pocket pain cohort (76.7%) when compared with the total SCS cohort (59.0%) (X2 = 5.93, P = 0.015). Diagnosis included failed back surgery syndrome (51.2%), complex regional pain syndrome (23.3%), and chronic neuropathic pain (25.5%). No patients improved with conservative therapy. All patients either went on to revision (n = 23) or explant (n = 20). Time from initial surgery to development of pocket pain was 7.5 months (range: 0.3-88) and from pocket pain to revision surgery was 4.5 months (range: 0.4-26). In addition, significantly more pocket pain patients (65.1%) had workers' compensation (WC) insurance compared with patients without pocket pain (24.9%) (X2 = 33.3, P < 0.001).
conclusionIn our institutional experience, pocket pain was inadequately managed with conservative treatments. Being female and having SCS filed under WC increased risk of pocket pain. Future work will explore the nuances in device placement based on body shape and manual activity responsibilities.
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