Six months ago, I had a spinal cord stimulator put in my spine to control chronic and severe back pain. At first I got great relief. My pain went from a 10 down to a two or three. Now it’s back up to a five. What happened?

A progressive loss of pain control is a yellow flag. It could mean there is a problem with the hardware. You’ll want to make an appointment with your physician to have this evaluated.

It’s also possible you are experiencing something called tolerance. This is not a true hardware problem. It’s probably not a biologic problem either. It’s more likely caused by neural plasticity.

This means the pain processing in the central nervous system builds up a tolerance to the stimulation. Eventually the signals are no longer blocked and more of the pain signals get through.

Experts aren’t sure yet how to best respond to this plasticity. Changing the placement of the electrodes may help. Altering the settings on the programmable unit may be a second option. Your surgeon is the best one to help you explore your options on this one.