Zapping the Pain Away 2013

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Advancements in Managing Chronic Pain for People with Spinal Cord Injury or Disease.

Chronic Pain. It’s a silent enemy. But for anyone who has it, chronic pain can take over your daily life. This webinar is designed to introduce you to technology options for managing chronic pain from surface stimulation to implanted devices. Learn about what it available and how to access these treatment options to zap the pain away.

SPEAKER: Jennifer French, Executive Director; Neurotech Network

Published in: Health & Medicine
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  • Another source of additional information might be patient information from the International Neuromodulation Society at http://www.neuromodulation.com/for-patients, which does cite the Neurotech Network in its explanations of neural prosthetics and functional electrical stimulation.
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  • Intro self
    SCI/user
    , 15 years post, using for 13.5
  • **create landing page with resources and link on home page***
  • FES Center Research facility
    Neurotech Network is a non-profit information source
  • The given definition collectively by the industry is (read definition)
    Before computers & cell phones, Mother Nature discovered that electrical signals provide the most efficient means of relaying information within the body. Without electrical signals, neurons could not communicate to allow us to see, hear, smell, touch, taste, move or think.
    Neurotechnology uses technology with the body to capitalize on the natural electrical signals to record neural signals or to excite neural cells.
    Health and Economic Impact: These are some of the resulted impact of using technology. This list is a collection from a variety of applications. Impact to an individual is dependent on the device, therapy, treatment and specific user circumstances.
  • http://projects.hsl.wisc.edu/GME/PainManagement/session2.4.html
    Nociceptive: represents the normal response to noxious insult or injury of tissues such as skin, muscles, visceral organs, joints, tendons, or bones.
    Examples include:
    Somatic: musculoskeletal (joint pain, myofascial pain), cutaneous; often well localized
    Visceral: hollow organs and smooth muscle; usually referred
    Inflammatory: a result of activation and sensitization of the nociceptive pain pathway by a variety of mediators released at a site of tissue inflammation.
    Examples include appendicitis, rheumatoid arthritis, inflammatory bowel disease, and herpes zoster.
    Neuropathic: pain initiated or caused by a primary lesion or disease in the somatosensory nervous system.Sensory abnormalities range from deficits perceived as numbness to hypersensitivity (hyperalgesia or allodynia), and to paresthesias such as tingling.
    Examples include, but are not limited to, diabetic neuropathy, postherpetic neuralgia, spinal cord injury pain, phantom limb (post-amputation) pain, and post-stroke central pain.
    According to the Neuropathy Association, there are more than 100 types of neuropathy. Approximately 30% of neuropathies are of unknown origin. Roughly another 30% of neuropathies are diabetic neuropathies
    Understand that classification of pain is not black and white and there is still pain that is not well understood. The Pathological processes never occur in isolation and more than one mechanism may be present and more than one type of pain. There are well-recognized pain disorders that are not easily classifiable. Our understanding of the causes of these disorders is still vague even though therapies to treat them are well known.
    Examples such as cancer pain, migraines and fibromyalgia.
  • American Society of Regaional Anesthesia & Pain Medicine, Int’l neuromodulation society
  • American Society of Regaional Anesthesia & Pain Medicine, Int’l neuromodulation society
    Poll:
    How many technology users do we have out there?
    Do you currently use one of the highlighted therapeutic technologies to treat your chronic pain?
    Yes
    No
  • Post website resources
  • TENS units (transcutaneous electrical nerve stimulation) and Percutaneous Neuromodulation Units (PENS) work by delivering low level electrical stimulation through electrodes placed directly on the skin of the affected area. The electrical stimulation delivered through the skin may help alleviate pain by blocking pain messages being sent to the brain.
    MET works the same way but uses very different waveforms, frequencies and pulse widths.
    Both systems require a physician prescription but this therapy can provide a convenient means of treating some forms of pain. Both are non-invasive and can be an economical solution.
  • PENS
    Deep Tissue electro therapy. Some in clinic, some at home. Two different electrodes: perc and surface and changes in stim delivery
    Algotec: AKA Electro-Acupucture. True electro acupucture is not widely available in the US, more so n Europe
    Both surface and percutaneous: facilitate motion with treatment, in clinic
    Uroplascity
    Helps where pain that inhibits therapy:
    Kelin winslow: nfl football, traumatic motorcycle, brown, buc,
    Limb pain, post surgical, arthritis
  • Implanted Drug Delivery Systems (IDDS), also known as Intrathecal Analgesia Therapy, refers to the administration of medicine, either pain-relieving or spasticity-relieving, such as baclofen, by a medication delivery pump. Typically for those for whom other treatements are not effective or side effects are difficult to tolerate.
    The IDDS include a chamber or reservoir for the drug that delivers the medication through a catheter directly into the spinal canal (intrathecal). The pump needs to be refilled, usually once every few months, by placing a needle through the skin. This procedure is typically performed on an outpatient basis or during a regular doctor’s visit.
    Generally, a person first undergoes a trial of the medication by an intrathecal injection. If successful, a pump system can be implanted permanently through a surgical procedure. IDDS reduce the need for oral medications, can be more effective and is now a mainstay of therapy for intractable pain including neuropathic pain and spasticity
  • Spinal Cord Stimulation (SCS) system is a hybrid system comprised of implanted electrodes in the spine and an external control unit. It uses electrical stimulation to block the pain pathways to the brain that travel through the spinal cord. SCS has also been known to decrease spasticity. An initial trial is needed to see if effective results can be achieved. If the trial is successful, a permanent system may be implanted. The user has the ability to keep the system on permanently or as needed.
    NOTE ON CONSUMER SUPPORT GROUPS
  • Anodyne Therapy - Anodyne® Infrared Therapy Systems are medical devices that are indicated to increase circulation and reduce pain, stiffness, and muscle spasm.
    The Fisher Wallace Stimulator™ is an external and portable stimulation for insomnia, anxiety, depression and pain therapy. It works by stimulating the brain's production of serotonin, GABA and beta-endorphins.
  • Neuros Medical - Developing Nerve Block technology for chronic pain. The Neuros Altius System consists of an implantable generator with an integrated rechargeable battery, cuff electrode, lead extension, and external devices (Clinician Programming Wand, Patient Controller and Charger). neuroma/residual limb pain, chronic post surgical pain, and chronic migraine: **Investigational** just released latest clinical trial data from European trials
    rTMS
    Repetitive transcranial magnetic stimulation (rTMS) of the cerebral cortex is a noninvasive strategy that could have the potential to relieve severe chronic pain, at least partially and transiently. The most studied target of stimulation is the precentral (motor) cortex, but other targets,
    Analgesic effects have been produced by rTMS in patients with neuropathic pain, fibromyalgia or visceral pain. Therapeutic applications of rTMS in pain syndromes are limited by the short duration of the induced effects, but prolonged pain relief can be obtained by performing rTMS sessions every day for several weeks. In patients who respond to rTMS but relapse, surgical implantation of epidural cortical electrodes and a pulse generator can be proposed to make clinical effects more permanent. The rate of improvement produced by rTMS may be predictive for the outcome of the implanted procedure. The place of rTMS as a therapeutic tool in the management of chronic pain remains to be determined.
    tDCS
    Transcranial Direct Current Stimulation (tDCS) is a non-invasive procedure in which a device sends a small Direct Current (DC) across the scalp to modulate brain function. The Soterix Medical 1x1 tDCS Low-Intensity Stimulator sends a low-level current from the positive electrode, anode, to the negative electrode, cathode. When the extremely low level current passes from the anode to the cathode, it may simultaneously increase the activity of the brain by the anode and decrease the activity of the brain near the cathode.tDCS mechanisms are considered to result from the ability of very weak DC currents to safely induce reversible changes in cortical plasticity. psychiatric disorders.
  • American Academy of Pain Management - The American Academy of Pain Management is an inclusive, interdisciplinary organization serving clinicians who treat people with pain through education, setting standards of care, and advocacy.
    American Chronic Pain Association - The American Chronic Pain Association was founded in 1980 by Penney Cowan in Pittsburgh, Pennsylvania.
    American Pain Foundation - Raising public awareness, providing practical information, promoting research, and advocating to remove barriers and increase access to effective pain management.
    National Chronic Pain Outreach Association - purpose is to lessen the suffering of people with chronic pain by educating pain sufferers, health care professionals, and the public about chronic pain and its management.
    The Mayday Pain Project - an education resource for a variety of pain and conditions resulting with chronic pain.
    NIH Neurological Disorders and Stroke—Chronic Pain - NINDS Chronic Pain Information Pages
  • French
  • Zapping the Pain Away 2013

    1. 1. Jennifer French, MBA Executive Director Neurotech Network Zapping the Pain Away: Technology and Pain Management www.NeurotechNetwork.org
    2. 2. Want to Ask a Question? Zapping the Pain Away: Technology and Pain Management www.NeurotechNetwork.org
    3. 3. Objectives • • • • Understanding the Pain Options for pain management Technology integration Resource to learn more Zapping the Pain Away: Technology and Pain Management www.NeurotechNetwork.org
    4. 4. Disclaimer page The information presented in this webinar is not meant to replace the advice from a medical professional. You should consult a health care professional familiar with your specific case, concerns and condition. Neurotech Network and its representatives do not endorse, rate, sell, distribute, prescribe, administer or recommend any products, procedures or services. We highly suggest for you to take information to a trained medical professional familiar with your case to discuss options that are best for you. Zapping the Pain Away: Technology and Pain Management www.NeurotechNetwork.org
    5. 5. Helping people regain life thru neurotechnology Focus on education of and advocacy to access neurotechnology devices, therapies and treatments for people living with impairments, their care-givers and medical professionals. www.NeurotechNetwork.org Zapping the Pain Away: Technology and Pain Management www.NeurotechNetwork.org
    6. 6. What is Neurotechnology? The application of medical electronics and engineering to restore or improve the function of the human nervous system. Zapping the Pain Away: Technology and Pain Management www.NeurotechNetwork.org
    7. 7. Types of Systems Zapping the Pain Away: Technology and Pain Management www.NeurotechNetwork.org
    8. 8. Types of Chronic Pain Source: University of Wisconsin School of Medicine Zapping the Pain Away: Technology and Pain Management www.NeurotechNetwork.org
    9. 9. Options for Pain Management Source: ARSA & INS Zapping the Pain Away: Technology and Pain Management www.NeurotechNetwork.org
    10. 10. Options for Pain Management Source: ARSA & INS Zapping the Pain Away: Technology and Pain Management www.NeurotechNetwork.org
    11. 11. Technology Integration TENS/MET/PENS IDDS SCS Nerve Block tDCS or TMS Zapping the Pain Away: Technology and Pain Management www.NeurotechNetwork.org
    12. 12. TENS/MET Transcutaneous Electrical Nerve Stimulation Microcurrent Electrotherapy Care Rehab www.carerehab.com Medical Science Products www.medsciencepro.com Dynatronics www.dynatronics.com Empi www.empi.com Neurotech Group www.NeurotechGroup.com Zapping the Pain Away: Technology and Pain Management www.NeurotechNetwork.org Electromedical Products Int’l www.alpha-stim.com NEUROMetrix www.neurometrix.com RS Medical www.rsmedical.com
    13. 13. Surface Electrodes Source: Axelgaard & Medical Science Products Zapping the Pain Away: Technology and Pain Management www.NeurotechNetwork.org
    14. 14. PENS Percutaneous Neuromodulation Systems Algotec www.algotec-ltd.com Biowave www.biowave.com SPR Therapeutics www.sprtherapeutics.com Zapping the Pain Away: Technology and Pain Management www.NeurotechNetwork.org
    15. 15. IDDS Implanted Drug Delivery Systems DePuy Synthes, Implantable Codman Pump www.depuy.com Medtronic ITB TherapySM Synchromed www.medtronic.com Zapping the Pain Away: Technology and Pain Management www.NeurotechNetwork.org
    16. 16. SCS Spinal Cord Stimulation Boston Scientific: Precision Spectra www.controlyourpain.com St. Jude Medical: Eon www.poweroveryourpain.com Zapping the Pain Away: Technology and Pain Management www.NeurotechNetwork.org Medtronic: Restore Sensor www.tamethepain.com
    17. 17. Alternatives FDA Clearance Anodyne® Therapy www.anodynetherapy.com Fisher Wallace Stimulator™ www.fisherwallace.com Zapping the Pain Away: Technology and Pain Management www.NeurotechNetwork.org
    18. 18. Alternatives Investigational Devices Neuros Altius System www.neurosmedical.com Soterix Medical 1×1 tDCS Platforms www.soterixmedical.com Zapping the Pain Away: Technology and Pain Management www.NeurotechNetwork.org NeuroStar TMS Therapy® System www.neuronetics.com
    19. 19. Considerations for Participating in any Pain Management Technology • Chronic Pain is a unique condition. Not all types of pain are alike. Not all programs are appropriate for all populations • Recommended Next Steps • Review resources provided here • If considering, use these resources to find a trained professional near you. • Make an appointment for an evaluation to see if you are a candidate • Commitments of self, family/caregiver • Time • Out of pocket cost and/or reimbursement • Medical Professional Monitoring • Peripheral nerve damage or skin damage • Device Maintenance Zapping the Pain Away: Technology and Pain Management www.NeurotechNetwork.org
    20. 20. Additional Resources  American Academy of Pain Management  American Chronic Pain Association  American Pain Foundation  National Chronic Pain Outreach Association  The Mayday Pain Project  NIH Neurological Disorders and Stroke—Chronic Pain NINDS Chronic Pain Information Pages Zapping the Pain Away: Technology and Pain Management www.NeurotechNetwork.org
    21. 21. Want to Ask a Question? www.NeurotechNetwork.org Zapping the Pain Away: Technology and Pain Management www.NeurotechNetwork.org

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