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New electrical devices replace drugs in fighting pain




Dr. Kestner

Dr. Kestner

Drugs have been the go-to treatment for centuries for pain control. However, the drugs used for severe pain have always carried serious risks. Newer drugs have become so powerful that their risk of addiction and death require tight control. In spite of considerable effort during the past decade, drug addiction related to pain medication is still a major problem, costing billions of dollars, lost productivity and countless lives.

Anyone who takes opioid drugs for pain runs a risk of addiction. The risk comes from the way the drugs interact with our brain and nervous system. The same chemical process that enables the drug to lessen the pain creates a strong chance that the body will become addicted to the drug.

The drugs work through molecules that interact with specific neurons in a way that blocks pain signals. Pain signals are transmitted along our nerve pathways using chemical reactions and electrical reactions.

 

 

Recent research has led to development of newer technology that utilizes electrical signals to block the pain instead of chemical drugs.

Electrical signals have been used for centuries to block pain. There are some indications that even ancient Egyptians used electrical fish and eels to lessen pain in a crude way. For the past hundred years or so, electrical medical devices have been utilized widely to treat painful conditions.

Most patients are familiar with devices generically known as TENS machines used to treat pain. They may have benefited from the treatment in a physical therapy or chiropractic office. TENS stand for Transcutaneous Electrical Nerve Stimulation. In other words, electrodes are place on the skin to transmit electrical impulses into the body in an effort to obtain a physiological effect.

Although patients may generalize and think all TENS units are about the same, there are actually many types of TENS or electrical stimulation used for therapy. The devices may provide stimulation that uses either direct current, such as comes from a battery, or an alternating current, which varies between positive and negative direction of flow of current in pulses. Besides controlling whether AC or DC, the signal can be varied in ways such as pulsed or constant flow, frequency of pulses, length of pulses, whether the pulses deliver the full current all at once or whether the signal is ramped up more gradually, the intensity of the current and so forth.

All of these factors have an effect on the outcome of the electrical signal. Some signals can be used to create a tingling sensation that blocks the pain by distracting the brain. Others can be used to stimulate muscles to contract. This can be useful to help muscles from becoming weaker after an injury or in some cases pumping body fluids through recovering tissue by rhythmic muscle contractions.

Although the electrical devices have been useful for decades in treating painful conditions, they are still often secondary to drugs because the devices are not effective enough to completely block strong pain. TENS devices only work temporarily while they are being applied.

About 30 years ago a new device hit the market that was a significant development in using electrical devices to treat chronic pain. Technological advances had reached the point that effective TENS units could be made small enough to be portable. Soon the devices were about the size of a deck of cards. They were powered by a 9-volt battery and could use self-adhesive electrode patches the patient could apply themselves. This meant the patient could take their therapy with them and resume more normal activities. Although these new portable TENS units were initially more than $1,000 and required a physician prescription, the devices are now available for less than $50 and can be bought by anyone. These portable TENS devices are still limited by the fact that the signal really only distracts the brain from the pain and the effect is mild and temporary.

The advances of technological development have brought about other more remarkable improvements. In our office we have been using two new technologies for the past three years that have resulted in extraordinary outcomes for many patients. Patients who have had chronic joint pain such as back, knee or shoulder pain and had relied on drugs for daily temporary relief are now able to have sustained relief that has lasted over two years and counting.

This new technology is substantially more effective at treating chronic pain compared to other widely available options.

Unlike TENS units, which use pulse ranges from 1 to 250 pulses per second, these newer devices use an electrical signal that is pulsed from 0.1 to 10,000 pulses per second. The devices use additional technology that allows the signal to penetrate several inches into the body, whereas the TENS units affect the body only superficially.

The result is that the newer devices can actually induce electro-analgesia, or a lack of sensation in the affected area. In addition to this, the effect of the new technology can accumulate in the body after subsequent uses and effectively create a lasting effect that can last for months or years as in the cases we have seen in our office.

The units are still expensive, costing up to $30,000 each or more, so they will not be in wide use for a while. Our clinic is fortunate enough to have a few of the devices available for patient treatment so we have been able to see numerous patients find remarkable relief for long-term pain issues. The devices can also be useful for treating neuropathy.

As the technology continues to develop and the prices drop over time, this new technology will move from select clinics such as ours into more mainstream treatment facilities. Perhaps within the next 20 years opioid addiction will be drastically reduced.

Dr. Mark Kestner is a licensed chiropractic physician and acupuncturist with 30-plus years of experience focused primarily on treating complex and chronic spine, joint and neurological conditions in Murfreesboro. His office is at 1435 NW Broad St. Contact him at mkestner@DrKestner.com.

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