Possible Therapies to Help Chronic Painby Amy Hendel, P.A. Health Writer
If you experience chronic pain then you know how difficult it can be to face life knowing that from the moment you wake up, you will have a level of suffering that can make living life and enjoying life incredibly difficult. Here are several exciting technologies that may solve or improve your chronic pain situation.
If you have any nerve-related pain then you may be familiar with traditional TENS therapy. TENS stand for Transcutaneous electrical Nerve Stimulation and the device works by sending stimulating (electrical) pulses across the surface of the skin and along nerve strands. Control settings allow you to increase or decrease the amplitude (intensity) of the current, by controlling the voltage of the device. You place the electrodes on specific body sites, depending on where the pain is and when the pulses are released, you feel a tingling or massaging sensation that helps to reduce the perception of pain.
One theory says it works by stimulating the release of endorphins (mood boosters which can also help to limit pain). Another theory is that the pulses interfere with the transmission of pain messages to the brain. It is a drug-free form of pain control. The Heat Pain Pro TENS Device, released by Omron HealthCare in October of 2016, delivers heat along with the TENS pulses to provide pain relief in joints and muscles. Along with the 27 heat settings, you can set the device to 20 different levels of pulse intensity. The device also has preset options depending on the location of the pain. It can be used to treat pain in the lower back, arms, legs, feet, shoulders and various joints. Retail suggested price is $89.99. It can be ordered online at omronhealthcare.com and also Amazon and at local pharmacies.
Another possibility is ActiPatch therapy. It’s non-invasive and involves an electroceutical device that utilizes electromagnetic fields to modulate nerve activity and “dampen” the brain’s perception of pain activity. The device actually pulses signals into the affected nerves generating the pain and prevents the brain from receiving the pain stimulus.
In a study that tested the device (compiled by the company directly), out of 5002 participants who reported feedback after using the device, 50 percent reported diminished use of medication need (including prescriptive strength drugs). Among the 5002 subjects, 67 percent reported the ability to stop or reduce the use of opioids, 70 percent reported improved sleep and 74 percent reported that they were able to increase physical activity after use of the device. There were no reports of feeling any residual tingling, heat or vibration post use, which is a sometimes complaint with use of TENS units. The ActiPatch is the only over-the-counter neuromodulation electroceutical device currently available. Individuals with diabetic neuropathy, patients with arthritis, and seniors with chronic pain can use the device and it can also be used if you have a pacemaker or implanted defibrillator.
Distributors offer the device nationwide.
Another technology is radiofrequency ablation (RF). The aim of this technology is to destroy nerves responsible for transmitting pain, or at minimum to interrupt and reduce pain signals. Devices that use this technology generate heat from medium frequency alternating currents to denervate tissues that are part of the peripheral nervous system. When the delivery method is via a catheter, it is called radiofrequency (RF) catheter ablation. Compared to invasive surgery, this technique is considered minimally invasive.
RF offers the advantage of being precise and reproducible and is considered somewhat effective in chronic pain management. The precise nature is due in part to the ability to first stimulate and very distinctly identify the nerve responsible for the pain, before the actual ablation technique is performed. That helps to provide a pretty good safety margin for the therapy.
The most common therapy involving RF is Lumbar Facet Nerve Abalation, which helps to alleviate low back pain that is due to nerves firing pain signals in the lumbar spine area. Other areas where RF may have success include the cervical spine, sacroiliac joint, and at an intervertebral disc area. It can also be used to alleviate the causes of some headaches. Risks include failure of the procedure, infection, bleeding, and neuritis. In some cases you can develop weakness or even paralysis, so the practitioner and the patient need to weigh the benefits versus the risks.
If you’re a techie then you know that virtual reality technology has been permeating the video game world and the field of health. DeepStream VR is a company that has managed to harness virtual reality for the purpose of treating chronic pain. Read more about this technology in an article Celeste Cooper, R.N., wrote for HealthCentral in October 2016.
Other technologies are available worldwide, including spinal cord stimulation (SCS), also called neurostimulation, which directs mild electrical pulses to interfere with pain messages that reach the brain. The device is implanted near the part of the spinal cord that is believed to have the activated nerves. This new version, called Burst DR, was devised by a physician and uses traditional spinal cord stimulation (SCS) along with delivering pulse “bursts” that mimic natural nerve impulse pattern in the body. The purpose of the “burst aspect” of the device is to prevent the body from becoming accustomed to SCS therapy, which is a common drawback. Researchers from the SUNBURST study (see page 7) looked at 100 patients enrolled in 20 centers nationwide, randomized to receive either tonic stimulation (SCS) or burst stimulation and then tonic stimulation (BurstDR using the new device). They noted that 89.4 percent of the subjects preferred the BURST stimulator for treatment of the chronic pain and 91 percent reported a decrease in parasthesia, compared to traditional SCS.
BURST has been available in Europe since 2014. You can read more about this device and technology on the St. Jude Medical website.
The takeaway from this column should be a sense of hope, given the unrelenting and debilitating nature of chronic pain. Always check with your doctor before trying any new treatments or therapies.