Indications for spinal cord stimulation (SCS) have increased as technology has improved. Some of the technological changes include rechargeable batteries, narrow lead spacing, constant current delivery, and improved software for better programming. The ability to produce effective paresthesias has enhanced with the new generation of stimulators. We recently performed an observational study in 8 patients where 4 extremity parethesias were obtained with lead placement in the lower cervical epidural space. Patients reported paresthesias with midline placement of leads consistent with dorsal column stimulation. Five of the patients did not have lower extremity pain and the paresthesias were coincidental findings. Three patients had some degree of pain in all 4 extremities and found the paresthesias effective in reducing pain in all extremities. Many chronic pain patients complain of pain in multiple extremities while others have migratory patterns. Further work is required to see if (SCS)placed in the lower cervical epidural space can provide long lasting analgesia.