https://www.technologyreview.com/s/608256/these-new-devices-promise-to-fight-pain-without-opioids/

Terri Bryant was working at a cheese factory in 2000 when she injured the delicate, rubbery discs between her spinal bones. That was the start of her chronic pain. Two years later, she had back surgery and started regularly taking fentanyl, a powerful prescription opioid medication. Her pain persisted even after a second surgery in 2009.

In 2012, Bryant enrolled in a clinical trial for a device known as a spinal cord stimulator, designed to alleviate back pain. The experimental device was implanted under the skin at the base of her spine. When turned on, it sends pulses of a mild electric current to the nerve fibers in her spinal cord.

The therapy is known as neuromodulation or neurostimulation, and scientists think it works by interrupting the pain signals that are carried from the nerves to the brain. The idea has been around since the 1960s, but in recent years the technology has undergone rapid innovation. While drug developers are trying to discover new nonaddictive medicine to treat pain, medical device manufacturers are racing to develop smaller, more comfortable implants as well as external devices that don’t require surgery. The stimulator Bryant got, called the Senza System, is one of a growing number of medical devices to treat pain.

Despite Americans’ overall pain remaining the same, the amount of opioids prescribed per person was three times higher in 2015 than in 1999, according to the Centers for Disease Control and Prevention. Meanwhile, an estimated two million people in the U.S. abused prescription opioid pain relievers in 2015. As the use of opioids in the U.S. skyrockets, new medical devices could be a drug-free alternative for some patients. For others already addicted to opioids, this technology may instead help alleviate the pain of withdrawal.

Comment;

Pain should be treated with multiple modalities.  Physicians know that when a single drug is given at high doses, side effects are more likely to occur.  Often we’ll use several drugs at lower doses to try to minimize this effect for that reason.  Pain responds to TENS units which are locally applied electrodes used to transmit low amounts of electrical energy across the painful area, think of it as “confusing” the pain fibers so that they don’t work as well.  Physical therapy can be very helpful as well.  Thermal therapy, heat for muscle spasms, cold for inflammation works well, sometimes used in an alternating fashion.  More and more pain specialists are trying to use these techniques to treat pain and if not eliminate, then at least minimize dosing of opiates.

Buprenorphine is another very effective medicine for relieving pain.  It’s also used to treat addiction–ideal for those addicts who ALSO have chronic pain!

Dr. Raymond Oenbrink
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