Over the past 35 years there have been massive changes in new pain management technologies. Many of these new pain management technologies and devices evolved because patients were rejecting the use of drug medications that failed to address the causation of the pain. Patients and Physicians were realizing the brain is merely the receptor of the pain impulses and the method of doping the brain involved too many risks as well as terrible side effects for the chronic pain patient. Brain medicating is no longer in vogue.
Patients also witnessed many surgical interventions that not only did not reduce the severity, duration or frequency of pain but in many cases exacerbated the original pain problems. The underlying post surgical outcomes often introduced new pain issues such as scar tissue formation which exacerbated the problems, and with implanted devices, such as dorsal column stimulators ( spinal cord stimulators), added to non function over time. Often the underlying surgery would only last for short durations and more surgery was needed, or the complications from additional surgery was not warranted. Scar tissue build up made later surgeries even more risky.
For many chronic pain patients they have learned, after many failed attempts using new or more powerful drugs and surgical intervention, that the causation of the pain can not be determined, or treated, so they deal with symptomatic treatment of pain. The reality of chronic pain is it is symptomatic, however the causation can not be treated or determined, and some interventions do not help, but harm. Drug medicating and surgical procedures often fall into the latter category.
Some of the new pain management devices that have emerged are lasers - in varying frequencies, thermal devices for deeper tissue heating and recently portable interferential therapy. Most are merely new delivery devices that deliver proven therapeutic benefits for treating pain using conventional methods.
None of the devices are "experimental" but are now becoming available to be used to self treat, away from the hospital or clinical setting. The treating principles have been around and successful for long time periods. The problem has been to receive clinical success the patient had to be in a clinic. The new devices are making those treatments an option that can be self administered. By being able to self treat the new devices are producing some new beneficial results such as the residual pain relief occurring after treatment that are encouraging.
Many of the newer technologies do involve surgery and implants, such as the previously mentioned spinal cord stimulators (SCS) or, in the most severe cases, the deep brain stimulators (DBS). One major reason for the implantation devices is the practical need to reduce resistance to the treated area by moving the device closer to the nerve root. In today's environment that is beginning to look archaic because one of the sole purposes of interferential therapy is to increase the frequency ( times machine goes off and on in a second), so the treating impulses can be delivered to the pain site(s). The ability to increase the frequency now allows for targeting the nerve roots or other neural structures since the higher frequencies have reduced the electrical resistance of the skin and the body. The rationale for surgical intervention no longer applies since the new interferential modality overcomes the purpose of the surgical procedure.
Eventually it may be discovered that the newer external devices can be used in a complementary manner to enhance the new genetic treatments that are becoming available. The external devices will prepare areas of pain for absorption of new gene therapies, or as appears to be happening with the interferential carryover effects, the therapy itself may be changing the underlying physical chemical structure and altering the process of pain stimulus which resolves the pain issues.
For now though the most recent, effective, FDA approved and Medicare reimbursable pain management device is the combined tens and interferential treatment device. Tens provides sensory relief only if the interferential carryover pain relief period has not extended long enough for the patient. It appears initially a patient can self treat and the carryover pain relief period may be for short durations. Over time the carryover is extended with an eventual goal of weekly or monthly treatments. This is far more desirable for the pain patient than having to wear the unit and treat constantly as one does with a simple tens unit.
Interferential therapy's main strength is the new ability to self treat with a portable device and achieve the pain relief treatment that has been enjoyed for decades outside the clinic or hospital. It appears interferential is changing the concept of treatment options for the often overlooked and under treated chronic pain patient.
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