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FDA Approved Uses of Electric Stimulation
1.
2. FDA Indications for Use
1. Management and symptomatic relief of chronic (long term)
intractable pain
2. Adjunctive treatment of acute, post-traumatic pain
3. Adjunctive treatment of post-surgical pain
4. Relaxation of muscle spasms
5. Prevention or retardation of tissue atrophy
6. Increasing or improving circulation
7. Neuromuscular reeducation
8. Immediate post-surgical use to prevent phlebothrombosis
9. Maintaining or increasing range of motion
3. FDA Indications for Use
1. Management and symptomatic relief of chronic (long term)
intractable pain
2. Adjunctive treatment of acute, post-traumatic pain
3. Adjunctive treatment of post-surgical pain
4. Relaxation of muscle spasms
5. Prevention or retardation of tissue atrophy
6. Increasing or improving circulation
7. Neuromuscular reeducation
8. Immediate post-surgical use to prevent phlebothrombosis
9. Maintaining or increasing range of motion
5. Signal Competition: (gate control theory)
Relaxation: (muscle – referred pain inhibition)
Hormonal Response: (neuropeptide release)
Ionic Movement: (enzyme / substrate orientation)
Membrane Response: (sustained depolarization)
Noise Effect: (signal scramble, no re-excitation)
Self-Organizing Effect: (post-hyperactivity inhibition)
Quantum Effect: (vector potential – polarization effect)
Mechanism Description
Electric Signaling Effects
6. Signal Competition (gate control theory)
Large diameter afferent nerve fibers carry signals faster than the small unmyelinated
pain fibers, creating activity in the inhibitory circuits at the dorsal horn “gate”. This
blocks the perception of pain. (Melzack and Wall)
Mechanism Description
Electric Signaling Effects
7. Relaxation / Anti-Spasmodic Effects
Muscle Function :
Relaxation and spasm release decreases referred pain.
Neuron Function - Exhaustion:
Higher-rate electrical signals producing repeated action impulse at a rate which
cannot be effectively followed by the human nervous system. This depletes the
synaptic transmitters necessary for continued action potential propagation.
Mechanism Description
Electric Signaling Effects
8. Hormonal Response: (neuropeptides)
Increase in Dopamine Concentration:
Electric Signaling (with specific parameters) significantly increases dopamine
concentration (pain inhibitory transmitter)
Decrease in Norepinephrine, Serotonin:
Electric signaling (with specific parameters) decreases norepinephrine and serotonin
(excitatory transmitters).
Mechanism Description
Electric Signaling Effects
9. Hormone Response
Endogenous Opiate Release:
Electric signaling induces the release of powerful endogenous opiates, like
enkephalins and endorphins (morphine effect)
ACTH Secretion:
Electric signaling induces ACTH secretion (MSH hormone). ACTH secretion-induced
melanin becomes insulators when electric cell signals exceed the sensory or motor
threshold (signal inhibition).
Mechanism Description
Electric Signaling Effects
10. Ion Movement
Pain Mediator (metabolite) Response:
Under the influence of alternating–polarity electric fields, ion movement balances
metabolite concentration differences (pH).
Metabolic Facilitation:
A direct Influence on enzyme/substrate activity, which increases the probability of
hormone/ligand “favorable” orientation, transition state and the breakdown of pain
producing metabolites.
Mechanism Description
Electric Signaling Effects
11. Cell Membrane Response
Sustained Membrane Depolarization:
Multiple electric signals, which fall within the refractory period of the cell membrane
induce sustained depolarization…inhibiting the transport of pain signals along the
nerve axon.
Second Messenger Formation (cAMP):
An influence on voltage-gated channels, initiating second messenger formation
(cAMP). This directs all “cell-specific” activity…activates regenerative processes and
the repair of the cell membrane.
Mechanism Description
Electric Signaling Effects
12. Noise Effect
Scrambling Out the Perception of Pain:
Electric stimulation produces noise signals that excite a large area of nerves, self-
focused nerve conduction cannot stabilize…the signal is diffused…no lateral
occurs, re-excitation is impossible.
Disturbance of the Self-Organizing Structure:
Chaotic self-organizing is a decisional factor of signal transmission in living systems
(neuronal pool)...spatio-temporal order is chaotically rearranged…neuronal pool
transmission is altered or inhibited.
Mechanism Description
Electric Signaling Effects
13. Quantum Effects
Cell Membrane Processes:
All microscopic events (cell membrane processes, biochemical events, etc. are
determined by quantum-mechanical rules… electromagnetic potentials determine
processes, not the field
Vector Potential:
Change in vector potential effectively alters the quantum bio-processes…all of the
micro-reactions are dynamical. Vector potential determines water polarization states
(sodium channel).
Mechanism Description
Electric Signaling Effects
14. Stimulatory Class
The physiological effects induced by repeated action potentials in cells
(depolarization and subsequent repolarization activitexcitabley).
Multi-Facilitation Class
The physiological effects induced without action potentials (NO
depolarization and repolarization activity). These include biochemical
effects.
Electric Signaling Classifications
17. Neuron Block (sustained depolarization)
Pain Mediator (metabolite) Redistribution
Cell Membrane Repair (cAMP)
Multi-Facilitory Class
Signal Example - Analgesia
18. Signal Energy Outcomes
pH normalization
Hormone/ligand activity imitation
Trophic improvement
Improved membrane permeability
Immune system support (Gap Junction)
via improved cell-to-cell communication
Activation of Regeneration…
Cell repair and normalization (cAMP)
19. cAMP Normalization
Up to 500% increase in intercellular cAMP via sustained cell membrane
depolarization
Clarence Cone MD, Ph.D. University of Virginia
Post-Hyperactivity Depression
Prolonged, hypo-excitable state of nerves arising from relatively short duration
electric signaling treatment
Robert Schwartz, MD Medical University of South Carolina
Signal Energy Outcomes