10 Things to Know about Neuromodulation and the International Neuromodulation Society
1. Neuromodulation employs medical devices to relieve symptoms through alteration, or modulation, of nerve system function.The International Neuromodulation Society defines neuromodulation as the alteration of nerve activity through the delivery of electrical stimulation or chemical agents to targeted sites of the body. Its uses span applications from chronic pain to neurological conditions and support of functional recovery of such abilities as hearing, vision, self-care or mobility.
2. The International Neuromodulation Society unites almost 2,000 members on six continents to advance skills and a knowledge base for the growing field. Developed over the last 45 years, neuromodulation has increasingly been used to treat conditions that become more prevalent in an aging population, such as Parkinson’s disease, chronic pain ranging from debilitating neuropathic back and leg (arm) pain to severe headaches, spasticity, epilepsy, and bladder and bowel disorders. It is also under study for conditions ranging from gastroparesis and chronic angina to stroke recovery and Alzheimer’s disease.
3. Neuromodulation is a new class of therapy.Conventional medicine often uses the biomedical model of disease management whereby the underlying cause is searched for and treated to relieve symptoms. But what happens if the underlying cause is not able to be treated? Neuromodulation involves directly treating the nervous system itself, often through small implanted devices that target a specific area, to rebalance the activity of neural circuits and manage symptoms as varied as severe unremitting neuropathic pain to severe movement disorders such as Parkinson’s disease, or urgency urinary or fecal incontinence due to overactive bladder or pelvic floor injury.
4. Neuromodulation is a cross-disciplinary field.Providers include neurosurgeons, pain physician specialists and rehabilitation physicians. They may often work with other specialists such as neurologists, psychiatrists, psychologists, gastrointestinal or colorectal specialists, urologists, primary care physicians, and physical therapists to achieve best outcomes.
5. Neuromodulation can alleviate or lessen pain, spasticity, or epileptic seizures without putting patients into a “drug fog.”By using neurostimulation or a drug-delivery system that provides micro doses of medicine, the patient can avoid some side effects, including excessive sedation or clouding of thoughts. Compliance is simple since delivery is automated through parameters set up by a clinician. At home, patients with chronic pain or movement disorder may wirelessly adjust settings within pre-established parameters. Use of neuromodulation often allows patients to lower their intake of medications to control symptoms, and may relieve symptoms that cannot be controlled by medication alone.
6. Potential neuromodulation patients can often “test drive” the modality. Common neuromodulation procedures such as spinal cord stimulation or peripheral nerve stimulation use minimally invasive techniques and patients undergo a temporary test before opting for a permanent implant. Even deep brain stimulation surgery for such conditions as Parkinson’s disease or essential tremor may entail patient feedback when targeting the location or degree of stimulation delivered.
7. Neuromodulation procedures are reversible. Devices can be turned off and, if desired, any compact, pacemaker-like medical implants removed.
8. Chronic pain costs the European healthcare system as much as €300 billion a year in medical treatment and lost productivity.A multi-country survey reported in 2013 shows that one out of five Europeans suffers from chronic non-cancer pain. That number holds true throughout the developed world, where 20 percent of people live with chronic non-cancer pain, according to the WHO. In 2011, the Institute of Medicine announced that more than 100 million Americans live with pain, at a cost of up to $635 billion each year.
9. Neuromodulation has been available for use in chronic pain and other indications for more than two decades, and the technology continues to develop and expand.Extensive research and clinical trials have documented neuromodulation’s ability to decrease chronic pain and improve the quality of life for patients. Established neuromodulation procedures are covered by most medical insurance and government healthcare programs in the USA and selected countries worldwide.
10. Neuromodulation is a real and growing healthcare application driven by advances in neuroscience capabilities.Advances in miniaturization, compact power supplies, and neuroscience have fueled growth of modern applications of neuromodulation, although awareness of the effects of nerve stimulation on chronic conditions can be traced back to ancient times; for instance, there are accounts in antiquity of using electric fish to manage chronic pain symptoms.
(Adapted from a document previously developed by an INS chapter, the North American Neuromodulation Society, NANS.)