Neuromodulation at Stanford: When Chronic Pain Needs a New Path
If you’re living with chronic pain, you may have tried many treatments—medications, injections, physical therapy—only to find that the pain still gets in the way of your life. At Stanford’s Division of Pain Medicine, we offer an advanced treatment called neuromodulation—a way to change how pain signals move through the body, using tiny electrical pulses instead of more medication.
In this blog, we’ll explain how neuromodulation works, who it can help, and what makes our approach different.
What is neuromodulation?
Sometimes called “electroceuticals,” neuromodulation is a therapy that changes how your nervous system senses and responds to pain. It does this by delivering small, safe amounts of electricity to certain nerves or to the spinal cord.
In simple terms: neuromodulation calms the overactive nerves that are stuck in a “pain loop.” Instead of trying to block pain with medication, it gently rewires how the body processes pain.
There are a few different types:
- Spinal Cord Stimulation (SCS): A device is placed near the spinal cord to reduce back or leg pain.
- Peripheral Nerve Stimulation (PNS): Targets a specific nerve—like those in the shoulder, knee, or face.
- Intrathecal Pain Pumps: Deliver medication directly to the spinal fluid, often used for cancer-related pain.
We think of this as “medicine by Edison”—using electricity instead of a pill, with the goal of long-term relief.
Who might benefit from neuromodulation?
Neuromodulation can help people with many kinds of chronic pain, especially when other treatments haven’t worked well. Conditions we commonly treat with this therapy include:
- Back and leg pain
- Complex regional pain syndrome (CRPS)
- Nerve pain from surgery, injury, or diabetes
- Pelvic or abdominal pain
- Neck, shoulder, and facial pain
“You can treat pain from head to toe using neuromodulation,” Dr. Leong explains. The key is finding the right treatment for the right person at the right time.
Stanford’s 4-legged chair: A whole-person approach
Many pain centers offer neuromodulation, but Stanford does it differently.
We don’t think of neuromodulation as a last resort. We see it as part of a complete pain care plan. Dr. Michael Leong, who leads our neuromodulation program breaks down care into “the 4 legs of the chair”:
- Medications
- Targeted injections
- Physical and functional therapies
- Mind-body support, like working with a pain psychologist
Just like a chair needs all four legs to be steady, pain care needs to address the body, the nervous system, movement, and mental health together. Neuromodulation fits into this model, often after other therapies have been tried or in combination with them.
Stanford's Michael Leong, MD, on "Technology for Back Pain: Spinal Cord Stimulation"
What makes Stanford’s neuromodulation program different?
- Patients don’t have to guess if it will work. Before receiving a permanent device, patients do a trial period with a temporary one. They’ll know within 5–7 days if it brings relief. This “test drive” helps patients feel confident before committing.
- We offer a structured, team-based process. Patients meet with a physician and a pain psychologist before beginning the procedure. Together, we look at their medical condition, any imaging they’ve had, and their personal goals.
- We time it carefully. Sometimes, people are referred to Stanford for a neuromodulation procedure after years of trying everything else. Other times, neuromodulation is introduced earlier. Either way, we aim to offer it when you’re ready, both physically and emotionally, to benefit.
- We innovate responsibly. We’re not just treating patients—we’re also leading national research. For example:
- We’re studying new waveforms that reduce pain without any buzzing or tingling.
- Our teams are testing remote programming, allowing patients to adjust settings without visiting the clinic.
- We’re expanding neuromodulation for hard-to-treat areas like the pelvis or abdomen.
- And we’re exploring muscle-based stimulation as a non-spinal alternative for back pain.
25 Years of Relief: One Patient’s Remarkable Response to Neuromodulation
After routine OB surgery, a middle-aged single mother developed severe nerve pain in her leg. She couldn’t walk. Her ankle was locked in a painful tiptoe position, and even light touch caused excruciating pain. Despite multiple visits to another health system, she was only offered medications like gabapentin and injections—none of which helped.
She came to Stanford for a second opinion. After careful evaluation, she received a spinal cord stimulator (SCS) implant. That was 25 years ago. Since then, she’s undergone a few battery replacements, but the device continues to provide lasting relief.
With her mobility and independence restored, she returned to work in childcare—a meaningful step for a former teacher’s aide and mother who once thought she might never walk again.
What are the risks?
With neuromodulation, the main concerns are infection or bleeding. That’s why we screen each patient carefully and only move forward if it’s safe.
Because Stanford is an academic medical center, we have pain specialists, surgeons, and hospital teams on call—so if something does come up, we can address it right away. And if needed, devices can be removed without major surgery.
When is the right time to ask about neuromodulation?
If you’ve been living with chronic pain and haven’t found lasting relief, it may be time to ask if neuromodulation is an option.
During your visit, we’ll walk with you through each step:
- Reviewing what you’ve tried
- Talking about your goals
- Deciding together whether neuromodulation might help
Neuromodulation is one of the fastest-evolving areas in pain medicine, and researchers are making steady progress—refining techniques, improving devices, and expanding who can benefit. For many, neuromodulation opens a door to less pain, more movement, and the freedom to return to the moments that matter.
