Spinal Cord Stimulation for PAD Leg Pain
When Surgery Isn’t an Option
For patients with non-reconstructable critical limb-threatening ischemia (CLTI) and the physicians who refer them: how spinal cord stimulation helps control ischemic rest pain and helps preserve mobility when medication, stents, and surgery aren’t an option.
For Patients and Families
How does peripheral artery disease (PAD) cause nerve pain?
PAD reduces blood flow to the legs and feet. Over time, that limited circulation damages the nerves themselves, not just the tissue around them. The result can be numbness, burning pain, or slow-healing sores. Because nerve damage from poor circulation tends to worsen without treatment, it’s worth addressing early rather than waiting it out.
What are the symptoms of nerve damage from PAD?
- Leg pain or cramping when walking or climbing stairs, which eases with rest (vascular claudication)
- Burning or aching pain in the feet and toes at rest, often worse at night when lying flat
- Coldness in the lower legs or feet
- Numbness or weakness in the legs
How is nerve pain from PAD treated when medication and surgery haven't worked?
For Referring Physicians
Candidacy for Spinal Cord Stimulation in Non-Reconstructable CLTI
Spinal cord stimulation (SCS) is worth considering for patients with ischemic rest pain from CLTI who are not candidates for surgical or endovascular reconstruction. The criteria below reflect the patient profile most likely to benefit; use them as a referral filter, not a substitute for vascular evaluation.
Eligibility Criteria
- Ischemic rest pain, with or without small non-healing wounds/skin lesions
- Resting ABI < 0.90
- Non-reconstructable CLTI (unsuitable for surgical/endovascular reconstruction)
- Evidence of poor tissue perfusion (TcPO₂ < 30 mmHg)
- Trial-to-permanent response: ≥50% pain reduction during SCS trial
Exclusion Criteria
- Intermittent claudication without rest pain
- Large/deep ulceration or extensive gangrene
- Active infection of lesions
- Life expectancy < 1 year
- Trial response < 50% pain reduction during SCS trial
How do I refer a patient?
Send ABI results, TcPO₂ if available, and prior revascularization history to us via electronic referral through your EMR or by fax at (855) 999-9207. We’ll confirm eligibility and schedule a trial evaluation. We provide a candidacy assessment within 5 business days.
Commonly Asked Questions
Is spinal cord stimulation (SCS) surgery?
Do I have to be admitted to the hospital for spinal cord stimulation (SCS) surgery?
Typically, this is an outpatient procedure and patients do not need to be admitted to the hospital for either the trial or permanent placement.
Is this covered by insurance?
Find out if SCS is right for you
If leg or foot pain hasn’t responded to medication, stents, or surgery, schedule a consultation to discuss whether you meet the criteria for spinal cord stimulation.