Temperature increases by kilohertz frequency spinal cord stimulation

•kHz-SCS deposits significantly more power in tissue compared to conventional SCS frequencies, reflecting increased duty cycle (pulse compression).•An experimentally verified bio-heat model shows SCS waveform power determines tissue heating and predicts temperature increases at the spine ~1 °C during kHz-SCS.•Tissue heating by kHz-SCS may impact short and long-term outcomes suggesting distinct strategies for waveform optimization and lead placement.