Neurostimulation Applied to Back Pain

For those suffering from chronic back pain, going about daily activities can be difficult and painful. Depending on the causes and severity, medication and physical therapy may help, but a strategy that tends to see more effectiveness is neurostimulation.

Roughly the size of a stopwatch, a neurostimulator is a surgically implanted device that delivers mild electrical impulses to the epidural area of one’s spine through medical wires, or “leads.” These signals create a tingling sensation in the area of the back that is causing the patient’s back pain. Relief comes due to neurostimulation modulating the signals of pain before they reach the brain, much like rubbing a sore spot after bumping into a table, only no initial pain is felt.

The neurostimulator is placed underneath the skin, most commonly on the abdomen. Special medical wires then extend from the device delivering stimulation. Appearing as just a small bump, neurostimulators make no noise, and are very easy to control.

Controlling the level of stimulation is as easy as pressing a button. Through a handheld programmer, patients are able to adjust the strength and location depending on daily activities. For example, exercise and physical activity may demand stronger stimulation than times in which patients are sleeping, or simply relaxing.

Neurostimulation is an effective way to reduce chronic pain for several areas of the body, depending on the source of one’s pain, which can greatly improve patients’ daily activities and overall quality of life. Those who have seen success experience anywhere from 50% to 70% less pain depending on the provider, and a reduced need for anti-inflammatory medications. Additional bonuses of successful implants include no damage to the spinal cord, easy adjustability, and the option to have the implant turned off.

However, there are risks that come with having a neurostimulator surgically implanted, much like all pain treatments. Common side effects of this procedure include little to no stimulation due to movement of the leads, stimulation in wrong areas of the body (also due to lead movement), pain at the site of the implant, and transmission problems between the implant and the handheld programmer. Some side effects may be more serious though.

Like most surgeries, the risk of infection is present. Hematomas and fluid is also prone to leaking where the stimulator was implanted. Further complications may require additional surgery to relocate, repair, or replace specific parts of the device, and in rare cases, spinal cord injury may occur due to incorrect placement.
As mentioned before, depending on one’s severity and causes of back pain, neurostimulation may be the best option in relieving symptoms. Therapy sessions are available for those that wish to test this strategy before having surgery, so speaking with your physician about whether or not this is the right decision for you is highly suggested.

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Innovation in the Treatment of PTSD

For veterans who may have difficulty attending in-person therapy sessions to treat posttraumatic stress disorder, a recent study has shown that treatment through video conferences, or “telemedicine,” can be just as effective.

Many individuals in need of PTSD services live in remote areas around the world where mental health care tends to be scarce. Traveling great distances in order to access this specific type of care is not always ideal, especially for those who already suffer from mental health problems, and it can also be a financial burden. Providing telemental health technology to individuals who would otherwise not be able to experience PTSD treatment is easing these burdens.

Offering both clinical and educational services, telemedicine utilizes communications technology in support and healthcare when distance becomes an issue. These services can include clinical assessment, psychotherapy (for individuals or groups), cognitive tests, and even general psychiatry.

Compared to prolonged exposure therapy conducted in the homes of patients, telemedicine yielded extremely similar results in terms of effectiveness. While some may argue that in-person treatment allows for a more personal, realistic style of therapy, statistics have shown that those who received the same treatment via video screens had similar levels of improvement.

Despite these results, therapy provided through the internet is among the most disputed forms of telemental health services available, due to the previously mentioned fact; it is less personal. Doctors and therapists have feared that their lack of physical presence allows for the patients to react negatively without control, though studies have proved otherwise.

An extremely important consideration in working with those who suffer from PTSD is establishing a sense of safety and comfort, which may prove difficult without actually being in the room. Tools and techniques that therapists have used in order to combat this obstacle include pre-treatment orientation sessions, utilizing fax machines or email to share documents and paperwork, and questionnaires allowing room for criticism or feedback.

Regardless of the criticism, the results of this study prove that there are very little differences in the outcomes of both in-person treatment and telemental treatment. This could change how mental health services are provided on several different platforms, as well as offer new ideas in the treatment of such problems.

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