Have you ever hit your knee on a table? Without even thinking about it, you probably start to rub the area as soon as you can because you know it will make it feel better. Mechanical stimulation (rubbing) overpowers the pain signal providing pain relief. This was the basis for the gate theory first published by Melzack and Wall in 1965. This sentinel work helped create the framework for our basic understanding of pain signals and pathways. Further research over the last 50 years has led to substantial advances in not only our understanding of how pain is transmitted, but ways to manipulate these intricate neurophysiologic systems. This has led to various electrical stimulation devices, which use electricity to try and hide pain. The most basic is a transcutaneous electrical nerve stimulation (TENS) device, but there are many other options including peripheral nerve stimulation, spinal cord stimulation, and dorsal root ganglion (DRG) stimulation. These devices are safe, effective, and allow patients to be pain- and medication-free. With a variety of device choices, our specialists at the Spine Institute of North America know the intricate details in order to help select the best option for you.
Basics of Neuromodulation
Any neuromodulation system consists of two basic pieces – an energy source and a way to deliver that energy to nerves (often in the form of wires). While this therapy has been around for many years, in the past 5-10 years there has been substantial improvement in the battery sizes, capabilities, and software that delivers the energy. With these technological advancements, there are more options than ever to treat a wide range of pathologies.
Treatment Options for Neuromodulation Therapy
- Transcutaneous electrical nerve stimulation (TENS)
- Peripheral nerve stimulation
- Spinal cord stimulation
- Dorsal root ganglion (DRG) stimulation
Are You A Candidate For Neuromodulation?
After an initial visit, our specialists will determine if you are a candidate for one of the stimulation systems. The first step for any system is to undergo a trial. Think of this as a test drive – a chance for you to try the therapy and see if it helps relieve your pain. This is also an opportunity to try the treatment in real life conditions – can you walk further? Can you stand longer? This is a critical period for the therapy to prove itself to you. All trials involve getting the wires placed percutaneously (through the skin) without any incisions and having the battery carried or taped onto the skin. After the trial, the device is removed without any permanent or lasting changes. If the trial was a success, then a minor surgical procedure follows to make the therapy permanent.
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