![]() ![]() ![]() SPRINT PNS works by targeting the peripheral nerves specific to the pain site and essentially “resetting” the signals these nerves send to the brain. Unlike other peripheral nerve stimulators, SPRINT PNS from SPR Therapeutics is specifically designed for short-term use-a maximum of 60 days-and has a battery pack that is attached to the skin. And he was really just so thrilled that he was able to get his life back.” Rethinking peripheral nerve stimulationĪnother technique for treating chronic pain is peripheral nerve stimulation (PNS), which targets the nerves that connect regions of the body to the spinal cord. “He went to a family reunion where he hadn’t seen some people for a few years, and people didn’t even recognize him after he got a spinal cord stimulator,” says Lakin. Lakin recounts having dinner with a young veteran who had been in debilitating pain for ten years. The effects of SCS can be profound for chronic pain patients, many of whom have struggled with daily pain and disability. Currently, the device is not labeled for that indication, but “if approved it could help a large number of patients,” says Lakin. In addition, a new randomized control trial is testing whether Proclaim XR can be used to successfully help people with low back pain who are not optimal surgery candidates. Patients also have the option to control their stimulator from a smartphone. Abbott’s SCS systems are upgradeable so that as new protocols are optimized, people with existing devices can upgrade their stimulation parameters. Newer SCS systems from Abbott and other companies have also been able to offer patients pain relief without eliciting paresthesia, a sort of tingling sensation that is used to cover up pain in some SCS protocols. An imaging study in rats presented at the 17th Annual Pain Medicine Meeting suggests that this intermittent dosing works because burst stimulation creates a “carry over” effect, where pain relief continues for a period after the stimulation is turned off. In one study, 46% of patients chose to continue using the lowest dose protocol (30 seconds stim, 360 seconds off), and 71% used stimulation for less than 4 hours a day. ![]() īurstDR stimulation is also “dosable,” meaning the on:off stimulation protocol is customizable. A randomized control trial of 100 patients found that patients experienced better pain relief with BurstDR stimulation than with tonic stimulation and 70.8% preferred the BurstDR stimulation to tonic stimulation at the end of the 12 week trial. A nonlinear charge accumulation phase in the waveform creates a signal that activates both the medial and lateral pain pathways in the brain, disrupting both the physical and emotional aspects of pain. (Image courtesy of Abbott.)Īccording to Lakin, BurstDR mimics natural firing patterns found in the brain. “When they do that, that typically requires more energy.”įigure 1. “Alternate stimulation systems typically use higher frequencies, higher amplitude signals as well as more constant therapy,” says Lakin. The BurstDR waveform delivers intermittent bursts of stimulation, requiring less energy than traditional tonic stimulation. Proclaim XR delivers a novel, proprietary stimulation waveform called BurstDR. While many SCS systems require daily recharging, Proclaim XR is a recharge-free device that can last as long as ten years. ![]() Food and Drug Administration (FDA) last year (Figure 1). One recent example is Abbott’s Proclaim XR, which received approval from the U.S. New technological advances have improved the efficacy of SCS devices and the user experience. A handheld controller can be used to change stimulation parameters. Connected to these leads is a small pulse generator placed under the skin, similar to a pacemaker. One of the most common neurostimulation techniques for chronic pain is spinal cord stimulation (SCS), in which lead wires with electrodes are placed in the epidural space between the vertebrae and the spinal cord. While doctors have used neurostimulation for pain since the 1960s, neurostimulation devices and protocols continue to evolve in the quest to offer robust pain relief without side effects. The next line of treatment often involves implantable neurostimulation devices that deliver electrical pulses to the spinal cord or peripheral nerves, interrupting pain signals before they reach the brain. “Patients have trouble just living a normal life, doing a lot of things that we take for granted.” “It’s a debilitating situation,” says Ryan Lakin, divisional vice president of R&D at Abbott. While some pain patients receive relief from physical therapy, medication, or surgery, others aren’t helped by these treatments. Around 50 million people in the United States live with-and suffer from-chronic pain. ![]()
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