The Current Fall 05 Issue

Text Box: “Fourteen years ago, on September 17, 1989, Art fell from a ladder and broke his neck in 6 places, ( vertebrae: C1 – C2 – C4- C5 – C7 & T1 ). He was paralyzed and being treated with heavy doses of Morphine for pain. Ultimately, a plate with 4 screws was installed at C4 and C5 and at long last - the ordeal was “almost” over – “except for the pain”. He had prescriptions for Vicodan, Lortabs, Marinol, Codeine-3 – virtually every narcotic that you could possibly think of to add to the list. He was fast running out of “effective” drugs to take. His friend, Steve Michelson, told him about a pain management surface stimulation device. He tried it and almost immediately – something miraculous occurred. No pain! The device, CT1, is an advanced TENS device for the control of acute and chronic pain at a variety of body sites. It connects to unique patented electrodes, which are designed to provide stimulation at superficial aspects of the peripheral nerve innervations to the region of pain. It is no bigger than a large faced sports watch with either a 2 or 4-pronged band-aid like adhesive strip – placed in the same position as the straps on a watch. “Amazing” – is the only word to describe this non-invasive pain management device.—Art is a user of the CT1 TENS unit provided by Cyclotec AMT

Text Box: typically for more than 6 months. Industry groups estimate that chronic pain afflicts approximately 25% of the US population and costs $70-100 billion per year in medical costs. Neurotechnology devices applied for pain management may be separated into four areas: Spinal Cord Stimulation, Percutaneous Neuromodulation Therapy, Surface Stimulation Systems and Transcranial Magnetic Stimulation. A further account of each area is discussed below. Spinal Cord Stimulation (SCS) SCS masks the pain signals delivered to the brain. It is applied to the dorsal columns of the spinal cord. Typically appropriate for complex pain syndromes, this treatment may not be for everyone and costs vary. According to researchers led by Rod Taylor of the Department of Public Health and Epidemiology at the University of Birmingham in the UK, there is a wide variation in costs associated with implanting the device and with post implantation time frame. With initial costs ranging from $8,800 to $19,500 this range is evident. But it was also reported that after about 2 1/2 years, the costs of SCS out perform those without SCS. This is the case as those persons without SCS “underwent more physician visits, specialist consultations, re-hospitalization, on-going therapy and diagnostic tests.” For a device that requires a surgical implantation, the risks need to be evaluated against the benefits. SCS allows for flexibility, portability and adjustments to the treatment; however they come with risks of infections, allergic reactions, hardware breakage, and scaring to name a few. The latest development in SCS has been the use of re-chargeable batteries. In considering this and any pain treatment, you and your medical professional must determine if this is a proper treatment for your specific condition. Percutaneous Neuromodulcation Therapy Also known as PNT, this treatment again uses the delivery of electrical stimulation to the spine. As a non-surgical procedure, this treatment is less invasive than SCS; however, the patient must still care for treatment areas. PNT uses electrodes that are temporarily inserted to paraspinal tissue with an extremely thin needle. The stimulation is sent near the peripheral nerve pathways where pain signals are processed and sent to the brain. The desired net effect is the calming of hypersensitive nerves that are creating the pain. This pain management technique can be provided in a series of outpatient visits. The focus is for the treatment of lower back pain, but is also available for the cervical region. The treatment cost is approximately $5,000 and may be covered by some insurers. Check with your providers for details. Surface Stimulation Systems TENS units (transcutaneous electrical nerve stimulation) has been around for decades. There is a new wave of devices available that are not like the ones on the market only a few years ago. They now come in the form of bandages, remote-controlled versions and even those to treat minor cuts and burns. Various surface stimulators are available for different parts of the body. TENS works by delivering a low level electrical stimulation through electrodes applied to the surface of the skin of the affectedarea. The FDA still requires a physician prescription but this therapy can provide a new and convenient means of treating pain. TENS units have long been used particularly by physical therapy professionals. Contraction of muscles in many areas of the body may help to alleviate pain and provide a mobile and economical solution. TENS units have long been approved by Medicare and private insurance carriers but investigation of your individual case in required. Transcranial Magnetic Stimulation (TMS) This therapy is still experimental but may have potential in the treatment of chronic pain. TMS is the use of powerful rapidly changing magnetic fields to induce electric fields in the brain by electromagnetic induction without the need for surgery or external electrodes. Repetitive transcranial magnetic stimulation is known as rTMS and it uses multiple pulses of magnetic stimulation. It is rTMS which is currently being investigated for the treatment of pain. For more resources, visit the Educate section of our website, www.NeurotechNetwork.org

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