Could neuromodulation be your solution to persistent pain?

Neuromodulation is an innovative medical treatment designed to help manage chronic pain and certain neurological conditions. By targeting the nerves directly with electrical or chemical signals, this therapy can reduce pain or improve symptoms when other treatments have been ineffective. For many patients, neuromodulation offers a way to regain control over their quality of life.

Revered pain medicine and neuromodulation specialist Dr Kavita Poply explains how it works, who it benefits, and what to expect from the procedure.

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What is neuromodulation?

Neuromodulation is a medical treatment that involves altering nerve activity to manage pain or other neurological conditions. It works by sending electrical or chemical signals directly to nerves to either stimulate or inhibit them. These signals can change how the nervous system transmits pain or other sensations to the brain. Neuromodulation is often used when traditional treatments, such as medication or physical therapy, have not provided sufficient relief.

Neuromodulation techniques are commonly used to treat chronic pain, movement disorders, epilepsy, and other conditions affecting the nervous system. The most common forms of neuromodulation include spinal cord stimulation, deep brain stimulation, and peripheral nerve stimulation.

How does neuromodulation work?

Neuromodulation devices either send electrical pulses or deliver medications directly to the nerves. For electrical stimulation, a device is surgically implanted, and electrodes are placed near the targeted nerves. The device sends mild electrical pulses to interrupt or modify pain signals before they reach the brain. By blocking or altering these signals, the patient feels less or no pain.

In some cases, neuromodulation can involve the delivery of drugs (such as pain-relief medication) directly to the spinal cord or other specific areas of the nervous system. This method targets specific nerves or areas of the brain to provide more focused relief.

Who can benefit from neuromodulation?

Neuromodulation is typically considered when other treatments have not been effective. Patients with chronic pain conditions, such as lower back pain, nerve pain (neuropathy), or pain from injuries, may find neuromodulation helpful. It is also used to treat neurological disorders like Parkinson’s disease, epilepsy, and certain types of headaches, such as migraines.

People with movement disorders, like essential tremor, or spasticity (muscle stiffness) caused by conditions such as multiple sclerosis, may also benefit. Neuromodulation can offer significant relief, improving quality of life by reducing symptoms that interfere with daily activities.

Is neuromodulation safe?

Yes, neuromodulation is generally considered safe, but like all medical procedures, there are potential risks. The safety of the treatment depends on the type of neuromodulation being used and the patient’s overall health. Common risks associated with neuromodulation procedures include infection at the site of the device, bleeding, or discomfort after surgery.

The devices themselves are highly advanced and are designed to minimise risks. Patients will typically have a trial period with a temporary device to ensure that the treatment is effective before committing to permanent implantation.

What happens during a neuromodulation procedure?

The procedure usually starts with a consultation with a specialist. The patient undergoes a series of assessments to determine if they are a suitable candidate for neuromodulation. If the specialist determines that neuromodulation could be beneficial, they will typically start with a trial phase.

During the trial, a temporary device is implanted, usually under local anaesthesia. The patient can go about their daily activities to see if they experience relief. If the trial is successful, the patient will return for a more permanent procedure, in which the device is implanted under the skin.

The procedure is minimally invasive, and patients are usually able to return home the same day or shortly after. Recovery time varies, but most patients are back to normal activities within a week or two.

Are there any side effects of neuromodulation?

Some patients may experience mild side effects after the procedure, such as swelling or discomfort at the site of the implant. These side effects are typically temporary and resolve on their own. Rarely, complications such as infections, bleeding, or device malfunction may occur. It’s important to follow your doctor’s post-procedure care instructions to minimise these risks.

Many patients experience significant improvements in their symptoms with little to no long-term side effects. It is essential to discuss all potential risks and benefits with your healthcare provider before undergoing the procedure.

How long does neuromodulation last?

The effects of neuromodulation can last for several years, depending on the type of device used and the patient’s condition. Some devices are rechargeable, allowing them to last longer. For electrical stimulation devices, batteries typically need to be replaced every few years.

The treatment can be adjusted over time as needed, and many devices allow for programming changes to better address the patient’s symptoms as they evolve. Patients usually have regular follow-up appointments with their specialist to ensure the device is working correctly.

What should I expect after the procedure?

After the neuromodulation device is implanted, most patients experience a gradual reduction in their symptoms over time. It may take a few weeks to notice significant improvements, as the body adjusts to the device.

Follow-up care is essential to monitor the device and ensure it is functioning optimally. Most patients are encouraged to remain active and continue their usual routine, but heavy lifting and strenuous activities may need to be avoided during the initial recovery phase.

If you would like to learn more about neuromodulation, book an appointment with Dr Poply via her Top Doctors profile today.