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Neuromodulation for Pain

Many types of neuromodulation exist.

Neuromodulation for pain management in particular is a well established and effective method for managing chronic pain within multidisciplinary care. Dr Andrew Zacest provides suitability assessments, pre-surgical consultation, and the procedure itself from select locations in Adelaide.

What is neuromodulation for pain?

Neuromodulation is a surgical therapy which involves stimulation of the nervous system to treat a variety of conditions including pain, movement disorders, impaired blood flow, angina and organ dysfunction.

The procedure involves placing one or more electrodes in whichever location is optimal for the individual patient. These are connected to a small battery which is implanted below the skin and delivers small electrical impulses.

How does neuromodulation work?

Neuromodulation helps manage pain by working directly on the nerves. The goal of neuromodulation for pain is improve the patient’s quality of life by reducing pain’s impacts.

Electricity is delivered by a battery to an electrode implanted within the nervous system – usually within the spinal cord, but sometimes within the brain or peripheral nerves also. This changes or modulates the function of neural networks which are damaged by various disease processes including chronic pain.

Essentially, small electrical impulses are used to confuse the affected nerves and alter pain signals before they reach the brain. As a result, the brain receives less pain signals and the patient experiences less pain.

What can neuromodulation treat?

Neuromodulation is a very diverse treatment that can improve many types of persistent pain. It is currently approved for treating chronic pain in the trunk and limbs, legs, pain from failed back surgery syndrome, and intractable lower back pain[1].

Neuromodulation has also been used to treat depression, obsessive-compulsive disorder, Tourette syndrome, and other psychiatric disorders. Additionally, it has seen success in managing muscular conditions such as urinary and bowel incontinence, spasticity, and cancer pain[2].

Deep brain stimulation, a type of neuromodulation, can treat conditions such as Parkinson’s and essential tremor. Dr Andrew Zacest has a particular clinical interest in this application, has presented   extensively and has published in peer-reviewed journals on the topic.

Are neuromodulators safe?

Modern neuromodulators have been used since the early 1960s and have been widely tested and researched. They are used because clinical trials have proved that they are safe and their benefits have been repeatedly shown to outweigh their associated risks. While it carries risks as any surgical procedure does, neuromodulation is considered safe provided it is performed by an expert.

Additionally, the field is constantly evolving. Improved devices and wider applications mean that neuromodulators are safer than ever before and yield higher rates of pain relief. Dr Zacest himself has studied neuromodulation extensively and presented on numerous occasions at meetings.

Can neuromodulation cure pain?

Although rarely curative, neuromodulation can be one part of a multidisciplinary approach to assist with the management of chronic diseases including pain and may allow reduction in pain intensity, medication used for pain, increased activity and participation in social activities.

Current studies show that over 80% of appropriately selected patients find that neuromodulation reduces their pain by 50% or more. While it may not fully alleviate symptoms of chronic pain, neuromodulation is typically considered very successful and may provide significant benefit in day-to-day life.

What are the benefits of neuromodulation?

  • Highly reversible – treatment can be ceased immediately if adverse effects are reported[3]
  • May substitute long-term drug therapy – reducing medication tolerance or addiction risks[4]
  • Cost effective – reduces or eliminates the ongoing purchase costs of medications[5]

Is neuromodulation right for me?

When used for pain management, a trial of stimulation is usually recommended to decide whether a permanent implant might be helpful. This trial involves placing external electrodes in the epidural space as a day procedure – these are left in place for 5-7 days and allow you to assess your level of pain relief at home. A 50% reduction in pain and improved day-to-day function is generally considered a successful trial and may indicate success for a permanent neuromodulator implant[6].

As neuromodulation is a surgical therapy, it will generally be recommended only if medications and other non-invasive approaches have failed to effectively control symptoms. Additionally, Dr Andrew Zacest will only recommend the approach if he believes it to be beneficial after a thorough assessment of your condition.

Where can I learn more about neuromodulation?

The following links provide more information on neuromodulation, its applications, and how it may help manage your pain.

[1] Song et.al, 2014

[2] International Neuromodulation Society, 2020

[3] International Neuromodulation Society, 2016

[4] International Neuromodulation Society, 2016

[5] International Neuromodulation Society, 2016

[6] International Neuromodulation Society, 2019

Neuromodulation for Pain

Many types of neuromodulation exist.

Neuromodulation for pain management in particular is a well established and effective method for managing chronic pain within multidisciplinary care. Dr Andrew Zacest provides suitability assessments, pre-surgical consultation, and the procedure itself from select locations in Adelaide.

What is neuromodulation for pain?

Neuromodulation is a surgical therapy which involves stimulation of the nervous system to treat a variety of conditions including pain, movement disorders, impaired blood flow, angina and organ dysfunction.

The procedure involves placing one or more electrodes in whichever location is optimal for the individual patient. These are connected to a small battery which is implanted below the skin and delivers small electrical impulses.

How does neuromodulation work?

Neuromodulation helps manage pain by working directly on the nerves. The goal of neuromodulation for pain is improve the patient’s quality of life by reducing pain’s impacts.

Electricity is delivered by a battery to an electrode implanted within the nervous system – usually within the spinal cord, but sometimes within the brain or peripheral nerves also. This changes or modulates the function of neural networks which are damaged by various disease processes including chronic pain.

Essentially, small electrical impulses are used to confuse the affected nerves and alter pain signals before they reach the brain. As a result, the brain receives less pain signals and the patient experiences less pain.

What can neuromodulation treat?

Neuromodulation is a very diverse treatment that can improve many types of persistent pain. It is currently approved for treating chronic pain in the trunk and limbs, legs, pain from failed back surgery syndrome, and intractable lower back pain[1].

Neuromodulation has also been used to treat depression, obsessive-compulsive disorder, Tourette syndrome, and other psychiatric disorders. Additionally, it has seen success in managing muscular conditions such as urinary and bowel incontinence, spasticity, and cancer pain[2].

Deep brain stimulation, a type of neuromodulation, can treat conditions such as Parkinson’s and essential tremor. Dr Andrew Zacest has a particular clinical interest in this application, has presented   extensively and has published in peer-reviewed journals on the topic.

Are neuromodulators safe?

Modern neuromodulators have been used since the early 1960s and have been widely tested and researched. They are used because clinical trials have proved that they are safe and their benefits have been repeatedly shown to outweigh their associated risks. While it carries risks as any surgical procedure does, neuromodulation is considered safe provided it is performed by an expert.

Additionally, the field is constantly evolving. Improved devices and wider applications mean that neuromodulators are safer than ever before and yield higher rates of pain relief. Dr Zacest himself has studied neuromodulation extensively and presented on numerous occasions at meetings.

Can neuromodulation cure pain?

Although rarely curative, neuromodulation can be one part of a multidisciplinary approach to assist with the management of chronic diseases including pain and may allow reduction in pain intensity, medication used for pain, increased activity and participation in social activities.

Current studies show that over 80% of appropriately selected patients find that neuromodulation reduces their pain by 50% or more. While it may not fully alleviate symptoms of chronic pain, neuromodulation is typically considered very successful and may provide significant benefit in day-to-day life.

What are the benefits of neuromodulation?

  • Highly reversible – treatment can be ceased immediately if adverse effects are reported[3]
  • May substitute long-term drug therapy – reducing medication tolerance or addiction risks[4]
  • Cost effective – reduces or eliminates the ongoing purchase costs of medications[5]

Is neuromodulation right for me?

When used for pain management, a trial of stimulation is usually recommended to decide whether a permanent implant might be helpful. This trial involves placing external electrodes in the epidural space as a day procedure – these are left in place for 5-7 days and allow you to assess your level of pain relief at home. A 50% reduction in pain and improved day-to-day function is generally considered a successful trial and may indicate success for a permanent neuromodulator implant[6].

As neuromodulation is a surgical therapy, it will generally be recommended only if medications and other non-invasive approaches have failed to effectively control symptoms. Additionally, Dr Andrew Zacest will only recommend the approach if he believes it to be beneficial after a thorough assessment of your condition.

Where can I learn more about neuromodulation?

The following links provide more information on neuromodulation, its applications, and how it may help manage your pain.

[1] Song et.al, 2014

[2] International Neuromodulation Society, 2020

[3] International Neuromodulation Society, 2016

[4] International Neuromodulation Society, 2016

[5] International Neuromodulation Society, 2016

[6] International Neuromodulation Society, 2019