Restorative Neurostimulation

IS RESTORATIVE NEUROSTIMULATION RIGHT FOR ME?

Restorative neurostimulation may be a good option if you have had chronic low back pain for at least six months and other treatments like medications, physical therapy, or injections have not provided lasting relief. It is often recommended for people whose pain gets worse when they stand or walk and feels better when they sit down. It can also be an option if you want to avoid surgery or reduce your need for pain medication.

This treatment is often used for mechanical low back pain, which happens when the muscles supporting your spine aren’t working well. It may also help people who still have back pain after surgery.

HOW DOES RESTORATIVE NEUROSTIMULATION WORK?

Restorative neurostimulation uses a small device, about the size of a matchbox, that is placed under the skin near your lower back or upper buttock. Thin wires, called leads, are placed near the nerves that control a muscle in your back called the multifidus. These nerves help the muscle work correctly to support your spine. Once the device is in place, it sends gentle pulses to these nerves. This helps retrain the muscle so it works better, which can reduce pain and improve movement.

Most people find the therapy program simple to follow at home. You will use a small remote control to turn the device on for 30 minutes, twice a day. You can do these sessions while resting in bed or sitting on the couch. As you continue these sessions, the muscle gets stronger and your back becomes better supported, helping to ease your pain.

PREPARING FOR TREATMENT

WHAT TO EXPECT: EVALUATION AND PROCEDURE

Your doctor will first do a thorough evaluation to make sure this treatment is right for you. This evaluation may include a review of your medical history, imaging (like an MRI), and a physical exam to check how well your back muscles are working. If restorative neurostimulation seems like a good fit, you can move forward with the implant procedure.

The implant is placed during an outpatient procedure, which means you go home the same day. You will receive local anesthesia to numb the area and light sedation to help you relax. Your doctor will make a small incision to place the device and the leads.

AFTER TREATMENT

WHAT CAN I EXPECT AFTER THE PROCEDURE?

You can expect some soreness around the incision site for a few days, but this usually improves quickly. Most people can shower within 48 hours and return to light activities in 3 to 5 days. The incision should heal within about 2 weeks, but during that time, the device itself will remain off. The device will be activated at your first follow-up visit, usually 10 to 14 days after surgery. At that appointment, your provider will program the device specifically for your needs and teach you how to use your handheld remote to begin your daily therapy sessions.

Pain relief does not begin immediately after the device has been activated. Instead, improvement usually starts within a few weeks of beginning to use the device regularly. As the muscle gets stronger over time, your back becomes more stable and your pain may improve even more. Many people experience a 50% or greater reduction in pain with this treatment, which can help them be more active and enjoy daily life again.

8 out of 10 patients reported substantial improvements in pain and/or function. 7 out of 10 patients voluntarily eliminated or reduced their opioid intake*

*Percent of patients that were on opioids at baseline: (1-Year= 31/65), (2-Year= 34/57), (3-Year= 36/51).

Clinical study data shows that patients experience progressive long-term improvements in pain and function, over time, demonstrating a durable, consistent, and restorative result.*

* Three-Year Durability of Restorative Neurostimulation Effectiveness in Patients with Chronic Low Back Pain and Multifidus Muscle Dysfunction. Neuromodulation Journal. Sept. 2022. Gilligan et. al.

Follow-up Care

You will have a follow-up appointment about 10 to 14 days after the procedure to check your incision, activate the device, and program the settings to fit your needs. After that, further follow-ups will happen at 1 month, 3 months, and 6 months to fine-tune the programming as your body heals and your back muscles regain their strength and stability. Additional follow-ups may be scheduled if needed.

The device battery usually lasts several years before it needs to be replaced. When the time comes, replacing the battery is a simple outpatient procedure.

If you ever notice changes in how well the device is working or if you feel any discomfort near the implant, it’s important to contact your doctor.

COMMON QUESTIONS ABOUT RESTORATIVE NEUROSTIMULATION

Will I still need medications after treatment?

Many people are able to reduce or even stop some pain medications after starting therapy, but this depends on how much your pain improves. Your provider will work with you to make a plan that fits your needs.

Is the device visible under my skin?

The device sits just under the skin and is not visible under most clothing. Once you heal, most people say they forget it’s even there.

Can I go through airport security with the implant?

Yes, you can safely go through airport security. You’ll receive a special implant card that you can show if needed.

What happens if I miss a therapy session?

Missing a session here or there isn’t a big deal, but regular sessions are important to get the best results. If you miss a session, just start again with the next one.

How long does the device last?

The battery typically lasts several years. When it’s time to replace it, the procedure is quick and much easier than the first implant.

 

If chronic low back pain is limiting your ability to stay active and enjoy life, restorative neurostimulation may be a treatment worth considering. Our pain management specialists can help you find out if this approach is right for you.