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Wearable Nerve Stimulator Improves Chronic Pain

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    Posted: Sep/18/2015 at 5:15pm

Wearable Nerve Stimulator Improves Chronic Pain

Pauline Anderson

September 17, 2015

LAS VEGAS — A noninvasive wearable nerve stimulator improves pain to the point of needing less analgesia in patients with neuropathy, arthritis, and other common forms of chronic pain, a new study shows.

"Our data suggest, and this is mimicked anecdotally, that this device works for about eight out of 10 people," said Shai Gozani, MD, PhD, president and chief executive officer, NeuroMetrix, manufacturer of the device.

Dr Gozani presented the company-funded study here at PAINWeek 2015. The device (Quell, NeuroMetrix) was approved for use by the US Food and Drug Administration in 2014.

Endogenous Opioids

The stimulator, inserted into a slim, lightweight band and worn on the upper calf, stimulates sensory nerves, which carry neural pulses to the brain. The pulses trigger release of endogenous opioids within the spinal cord.

Dr Shai Gozani

"It elevates endogenous opioids, so it's actually operating through some of the same pathways as opioids," explained Dr Gozani. "But because it's all endogenous, it's very precise and doesn't have some of the negative side effects of prescription opioids such as addiction or euphoria; this is purely for pain control."

The class 2 medical device is the first of its kind and recently became available over the counter.

Based on TENS

Although the Quell device is relatively new, it uses the concept of transcutaneous electrical nerve stimulation (TENS), which has been around since the early 1970s. "We wanted to put it into a format that someone could wear for chronic pain relief: for an hour before going to bed, for 8 hours a day, overnight, or wear it continuously," said Dr Gozani.

The device is calibrated to the individual patient's sensory threshold and automatically sets stimulation intensity to a therapeutic level. After calibration, each 60-minute therapy session starts automatically every other hour.

The system brings pain relief in as little as 15 minutes, according to the company. It seems to work well for musculoskeletal and neuropathic pain, but because the device blocks pain signals at the level of the brain stem, it does not ease headache pain such as migraines, said Dr Gozani.

As it is worn on the upper calf, it is "convenient and accessible and discreet," said Dr Gozani. "You can wear it under clothing, under a dress or pants."

There is now also a smartphone app for users to track their therapy.

Study Results

The new study of the device included 88 chronic pain patients at least 40 years old (mean age, 55.7 years), which represented 67.7% of the number initially enrolled. Most (61.4%) patients had arthritis, with the next most common pain conditions being sciatica, fibromyalgia, and neuropathy.

Participants were asked to use the device at home on a daily basis for 60 days to manage pain. They then completed an online questionnaire.

The researchers found that 80.7% of subjects reported either much improved or improved chronic pain, as measured by the five-point Patient Global Impression of Change scale (95% confidence interval, 72.4% - 88.9%).

About two thirds of patients reported a reduction in use of pain medication: 31.8% said it was decreased a lot, and 35.2% said it was reduced a little.

Limitations of the study were that it was open label and did not determine the reason for lack of response to the follow-up questionnaire, and device utilization was self-reported, rather than obtained from electronic logs.

As with any pain therapy, the device does not work for everyone, said Dr Gozani. "I feel like it works broadly, but in any given category, not everyone is going to benefit."

The device costs $250. Each electrode lasts about 100 hours, so with typical use, it needs replacing every 2 weeks, at a cost of about a dollar a day.

It is contraindicated with pacemakers and defibrillators.

Dr Gozani founded NeuroMetrix in 1996 as a spinoff from the Harvard-MIT Division of Health Sciences and Technology.

Medscape Medical News asked Mathew M. John, DPM, a podiatric surgeon and medical director, Atlanta Center for Foot & Ankle Surgery, Marietta, Georgia, to comment on the device.

He said he has used it on patients with chronic foot pain who have failed multiple traditional treatments.

"I find that patients are more compliant, more motivated in using Quell before considering other invasive surgery options," Dr John said. "Quell has been a tremendous advantage in my practice by allowing me to offer an advanced treatment modality with little to no disadvantages or side effects."

The study was funded by NeuroMetrix. Dr Gozani is chief executive officer of NeuroMetrix. Dr John has disclosed no relevant financial relationships.

PAINWeek 2015: Poster 50. Presented September 10, 2015.



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Post Options Post Options   Quote Hangingon Quote  Post ReplyReply Direct Link To This Post Posted: Sep/19/2015 at 11:18am
Omg my pain Dr. told me about this a month ago and how it would be good for my pain I get in my feet. He said it should be available soon. What sucks is I'll never be able to afford this. I'm gonna copy this info and show it to him.

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Post Options Post Options   Quote Merlin Quote  Post ReplyReply Direct Link To This Post Posted: Sep/19/2015 at 12:30pm
I like the thought of those too Elizabeth - there are times when I would like something like that on my shoulders  it is so hard to reach around and hit the pressure points that cause what is sometimes called "grateful pain"
 
Now and again I will do a bit of acupressure on someone else's shoulders and they moan "Oh ah - mmmmmmm -  - don't stop - that's wonderful" - and I know myself that it really hurts but people want it and so do I
 
So yes- I wonder if they have these for shoulders - it looks like a brilliant idea
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Post Options Post Options   Quote Stevie Quote  Post ReplyReply Direct Link To This Post Posted: Sep/19/2015 at 12:45pm
Originally posted by Merlin Merlin wrote:

I like the thought of those too Elizabeth - there are times when I would like something like that on my shoulders  it is so hard to reach around and hit the pressure points that cause what is sometimes called "grateful pain"
 
Now and again I will do a bit of acupressure on someone else's shoulders and they moan "Oh ah - mmmmmmm -  - don't stop - that's wonderful" - and I know myself that it really hurts but people want it and so do I
 
So yes- I wonder if they have these for shoulders - it looks like a brilliant idea


The article states that:

"The system brings pain relief in as little as 15 minutes, according to the company. It seems to work well for musculoskeletal and neuropathic pain, but because the device blocks pain signals at the level of the brain stem, it does not ease headache pain such as migraines, said Dr Gozani."

So, yes it works on all parts of the body with the exception of migraines.


Please donate to help Chronicpainsite.com continue to help others.

My journey with chronic pain began over 30 years ago, while as a young nurse working spinal rehab, I injured my back lifting a patient. I am now fused from L2-S1. I have multiple thoracic and cervical issues. I'm a retired RN/PA and I know and understand the frustrations on both ends of the treatment spectrum of dealing with CP. It's been my goal since 2008, when we started this site, to reach out and help as many people in pain as possible. We will continue the fight as long as we can. Please, if you can help us continue to help you and others, donate. Thank you.
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Post Options Post Options   Quote Merlin Quote  Post ReplyReply Direct Link To This Post Posted: Sep/19/2015 at 1:08pm
Thanks for telling me that - although at this time there is not thought of any surgery for either shoulder in the near future they can get very uncomfortable and I sometimes get an electric-shock-like feeling
 
That sounds great - much easier than lying on the floor on a paper weight - that does help - and electrical pulse sound like something I could really benefit from.
 
I will have to find out where they are available in Australia
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Post Options Post Options   Quote Hangingon Quote  Post ReplyReply Direct Link To This Post Posted: Sep/19/2015 at 3:14pm
I would need one for each foot that would be $500 I can't even dream about owning something like that. I doubt if insurance would pay for it if its OTC. I'm not even gonna think about it cause then I'll be upset again.


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Post Options Post Options   Quote Stevie Quote  Post ReplyReply Direct Link To This Post Posted: Sep/19/2015 at 3:35pm
Only one device is needed for the entire body.


Please donate to help Chronicpainsite.com continue to help others.

My journey with chronic pain began over 30 years ago, while as a young nurse working spinal rehab, I injured my back lifting a patient. I am now fused from L2-S1. I have multiple thoracic and cervical issues. I'm a retired RN/PA and I know and understand the frustrations on both ends of the treatment spectrum of dealing with CP. It's been my goal since 2008, when we started this site, to reach out and help as many people in pain as possible. We will continue the fight as long as we can. Please, if you can help us continue to help you and others, donate. Thank you.
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Post Options Post Options   Quote Tas Quote  Post ReplyReply Direct Link To This Post Posted: Sep/19/2015 at 4:19pm
Merlin,

I would say they are available in Australia as this sounds like the device that was offered to me last week if the other procedures fail to produce the results they are looking for.

Ken

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L1/2 Mild bilateral facet astropathy. L2/3 same as L1/2. L3/4 ditto. L4/5 Disc bulge indenting anterior thecal sac. Bilateral facet astropathy. Mild canal and left foraminal stenosis. L5/S1 Severe disc narrowing with extensive osteophytes. Broad based disc osteophyte protusion indenting anterior thecal sac and resulting in a right foraminal stenosis. Exiting L5 nerves intact. Osteophytic contact with descending right S1 nerve root. Conclusion_ Severe degenerative disc changes L5/S1 with disc-osteophyte protusion. Moderate disc bulge L4/L5 Moderate central spinal stenosis with obileration of the epidural fat and distortion of the thecal sac. L5/1 Decreased disc height and signal. Super Ventricular Tachacardia. (SVT) Type 2 Diabetes, Arthritis knees and hips.
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Post Options Post Options   Quote Merlin Quote  Post ReplyReply Direct Link To This Post Posted: Sep/19/2015 at 8:37pm
I am so sorry Elizabeth - that is so disappointing for you
Ken - I will look into this - I am glad they are available in Australia - I guess I can find them on the internet - and thanks for the info
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Post Options Post Options   Quote Hangingon Quote  Post ReplyReply Direct Link To This Post Posted: Sep/19/2015 at 11:25pm
ok just spent almost 2 hrs reading  about this item. First only available in the United States. I looked at there fb and hardly any reviews just mainly advertisement. Did see some parts that people said its a joke, so really don't know what to say. I know I can't take the chance with that amount of money. I will keep looking up stuff on it.
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Post Options Post Options   Quote Tas Quote  Post ReplyReply Direct Link To This Post Posted: Sep/19/2015 at 11:33pm
Elizabeth and Merlin,

When I see the PM Specialist again in a few weeks I will try and clear up what he was referring to when he talked about something similar. At first I thought he may have been talking about a pain pump, then I quickly gathered that that was not correct.

A lot of things were discussed, I was given a lot of hard copy to read, so I will clarify some points next visit.

Ken

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L1/2 Mild bilateral facet astropathy. L2/3 same as L1/2. L3/4 ditto. L4/5 Disc bulge indenting anterior thecal sac. Bilateral facet astropathy. Mild canal and left foraminal stenosis. L5/S1 Severe disc narrowing with extensive osteophytes. Broad based disc osteophyte protusion indenting anterior thecal sac and resulting in a right foraminal stenosis. Exiting L5 nerves intact. Osteophytic contact with descending right S1 nerve root. Conclusion_ Severe degenerative disc changes L5/S1 with disc-osteophyte protusion. Moderate disc bulge L4/L5 Moderate central spinal stenosis with obileration of the epidural fat and distortion of the thecal sac. L5/1 Decreased disc height and signal. Super Ventricular Tachacardia. (SVT) Type 2 Diabetes, Arthritis knees and hips.
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Post Options Post Options   Quote Hangingon Quote  Post ReplyReply Direct Link To This Post Posted: Sep/19/2015 at 11:50pm
Here is a fb page about it.  www.facebook.com/quellrelief?sk=reviews.
Tas they said they are trying to make it available for Europe ,New Zealand and Austrialia. but right now only the USA.

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Post Options Post Options   Quote Merlin Quote  Post ReplyReply Direct Link To This Post Posted: Sep/20/2015 at 8:33am
Thanks for this guys - I would want to know more about it before I paid that much for something anyway
 
The world of advertising is overpowering and often not true
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Post Options Post Options   Quote Mopar1 Quote  Post ReplyReply Direct Link To This Post Posted: Feb/19/2018 at 7:09pm
Are these available in Canada?
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Post Options Post Options   Quote Jeff Quote  Post ReplyReply Direct Link To This Post Posted: Feb/19/2018 at 8:57pm
Sounds like a rip off to me.  Snake oil.  

TENS only works for muscle spasm type pain.  It does ZERO to block true nerve pain and orthopedic pain.  If I have a muscle spasm in my back, I can slap on a TENS, which is what I would choose over this goofy contraption.
Ankylosing spondylitis resulting in fusion of entire cervical, thoracic, lumbar, and SI joints, osteoporosis, 5 compression fractures, severe stenosis of spinal cord & nerve root compression, cervical myelopathy, radiculopathy, bruise & permanent deformation of spinal cord, incomplete spinal cord injury, postlaminectomy syndrome of cervical region, chronic nerve and orthopedic severe pain, and bilateral carpal tunnel. Asthma, GERD, high blood pressure, high tryglycrides, diverticulosis, recurrent pneumonia, anemia, hypertension, chronic dry eye and mouth. Need hip & knee replacement and fusion of both feet. Already had 11 surgeries including 5 orthopedic & 1 neurosurgery.

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Post Options Post Options   Quote Stevie Quote  Post ReplyReply Direct Link To This Post Posted: Feb/19/2018 at 10:46pm
I posted this 3 years ago and have never heard another word about it. I’d forget about it to be honest.

Please donate to help Chronicpainsite.com continue to help others.

My journey with chronic pain began over 30 years ago, while as a young nurse working spinal rehab, I injured my back lifting a patient. I am now fused from L2-S1. I have multiple thoracic and cervical issues. I'm a retired RN/PA and I know and understand the frustrations on both ends of the treatment spectrum of dealing with CP. It's been my goal since 2008, when we started this site, to reach out and help as many people in pain as possible. We will continue the fight as long as we can. Please, if you can help us continue to help you and others, donate. Thank you.
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