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Pain Management Treatment Overview
There are many areas of neurotechnology in the treatment of pain. This is an overview of three basic areas of treatment that are currently available; transcutaneous electrical nerve stimulation (TENS), implanted drug delivery systems (IDDS) and spinal cord stimulators (SCS).
- TENS units (transcutaneous electrical nerve stimulation) and Percutaneous Neuromodulation Units (PENS) work by delivering low level electrical stimulation through electrodes placed directly on the skin of the affected area. The electrical stimulation delivered through the skin may help alleviate pain by blocking pain messages being sent to the brain. Both systems require a physician prescription but this therapy can provide a convenient means of treating some forms of pain. Both are non-invasive and can be an economical solution.
- Implanted Drug Delivery Systems (IDDS), also known as Intrathecal Analgesia Therapy, refers to the administration of medicine, either pain-relieving or spasticity-relieving, such as baclofen, by a medication delivery pump. The IDDS include a chamber or reservoir for the drug that delivers the medication through a catheter directly into the spinal canal (intrathecal). The pump needs to be refilled, usually once every few months, by placing a needle through the skin. This procedure is typically performed on an outpatient basis or during a regular doctor’s visit. Generally, a person first undergoes a trial of the medication by an intrathecal injection. If successful, a pump system can be implanted permanently through a surgical procedure. IDDS reduce the need for oral medications, can be more effective and is now a mainstay of therapy for intractable pain including neuropathic pain and spasticity.
- Spinal Cord Stimulation (SCS) system is a hybrid system comprised of implanted electrodes in the spine and an external control unit. It uses electrical stimulation to block the pain pathways to the brain that travel through the spinal cord. SCS has also been known to decrease spasticity. An initial trial is needed to see if effective results can be achieved. If the trial is successful, a permanent system may be implanted. The user has the ability to keep the system on permanently or as needed.
These above options should be discussed with a medical professional trained in interventional pain medicine. Deep brain stimulation, transcranial magnetic stimulation and the use of very high frequency alternating currents as a method for blocking nerve conduction in peripheral nerves is currently under investigation. These methods might be able to provide an improved alternative for blocking pain and controlling muscle spasms. To discover more about available clinical trials, visit www.clinicaltrials.gov
Special appreciate to Dr. Elliot Krames, MD, International Neuromodulaton
Society and Dr. Thomas Keller, MD, Pacific Pain Treatment Centers for their contribution creating this introduction
Description of Different Types of Neurological Pain
- Neuropathy Neuropathic pain arises from nerve injury, as the
INS describes in this overview about this chronic condition that lasts
from months to years. A Fact Sheet of a further description of Neuropathy; courtesy of INS
- Neuropathic Pain Since the 1980s, neurostimulation has been an
option for controlling symptoms of chronic neuropathic pain, and use of
the therapy continues to spread as the technology itself advances. A Fact Sheet of a further description of Neuropathic Pain; courtesy of INS
- Painful Peripheral Neuropathy The INS explains this condition as "a common
neurological disorder characterized by numbness, weakness, tingling and
pain, often starting in the hands or feet. A Fact Sheet of a further description of Peripheral Neuropathy; courtesy of INS
- Complex regional pain syndrome (CRPS)
The key symptom of CRPS is continuous, intense pain out of proportion to the severity of the injury, which gets worse rather
than better over time. CRPS most often affects one of the arms, legs, hands, or feet. Typical features include dramatic changes in the color and temperature
of the skin over the affected limb or body part, accompanied
by intense burning pain, skin
sensitivity, sweating, and swelling.A Fact Sheet of a further description of CRPS; courtesy of NINDS
Pain Management Devices
TENS and PENS units
Implanted Drug Delivery Systems (IDDS)
- Algotech Ltd. - Providing a Neurostimulation PENS Therapy for chronic pain.
- Axelgaard - Their PALS Electrodes have become the world wide brand of neurostimulation electrode.
- Axiobionics, LLC - Wearable therapies are custom build external electrical stimulation systems
- Biowave - They designed 3 pain therapy devices all using percutaneous neuromodulation therapy delivering therapeutic electrical signal into deep tissue: Deepwave, Homewave and Sportswave.
- Care Rehab - They offering TENS units for the treatment of pain.
- Dynatronics - Providing self administered TENS devices to manage post-traumatic or post-surgical pain.
- Electronmedical Products International - Alpha-Stim device treats pain and stress related disorders with a proven, safe, effective non-drug approach
- Empi, Inc. - Empi's extensive line of rehabilitation products offer solutions for a variety of health care needs, including pain control options.
- Medical Science Products - Specializing in non-invastive electrotherapy devices.
- NeuroMetrix - Offering the SENSUS device focusing on treatment for painful diabetic neuropathy.
- Neurotech - Wearable TENS units for the treatment of chronic pain including Baxolve XP, Aviva TENS XP and Recovery Back devices.
- RS Medical - offering pain and function solution stimulators to treat painful muscle conditions and to treat persistent back and neck pain.
- SPR Therapeutics
- offering a peripheral nerve stimulation system for shoulder pain.
Spinal Cord Stimulation (SCS)
- Codman - Implantable drug delivery system for the treatment of pain and spasticity.
- Medtronic - ITB Therapy for severe spasticity.
- Boston Scientific Neuromodulation
- a global leader in the development of implantable, high-technology
neurostimulation devices. Our bionic technologies include new spinal
cord stimulation treatments for chronic pain.
- Medtronic, Inc. - Medtronic Pain Therapies™ offer proven, effective relief treatment alternatives of spinal cord stimulation.
- St. Jude Medical Neuromodulation
- has successful neurostimulation and drug pump technologies advancing
treatment standards for chronic pain and neurological disorders
- Anodyne Therapy - Anodyne® Infrared Therapy Systems are medical devices that are indicated to increase circulation
and reduce pain, stiffness, and muscle spasm.
- Fisher Wallace Laboratories - The Fisher Wallace Stimulator™
is an external and portable stimulation for insomnia, anxiety, depression and pain therapy. It works by
stimulating the brain's production of serotonin, GABA and
- Neuros Medical - Developing Nerve Block technology for chronic pain.
Pain Support Organizations
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