Dr Simon Thompson
Consultant in Pain Management
An electronic implant is bringing relief and improved muscle function to long-suffering back pain patients as evidence reveals some are now virtually pain-free.
Restorative neurostimulation is an emerging therapy for multifidus dysfunction, a primary underlying cause of chronic mechanical low back pain. According to Consultant Dr Simon Thomson, Consultant in Pain Medicine at Mid and South Essex NHS Foundation, it is having a major impact on sufferers by treating the underlying cause of their low back pain, not just managing their pain or treating their symptoms. “The effects, I would say, are profound; in many cases, patients who had years of chronic back pain are now virtually pain-free.”
Implant gives more than just back pain relief
Dr Thomson is an expert in spinal cord stimulation who founded the Neuromodulation Society of the UK and Ireland in 2000. For the past five years, he and his research colleagues have provided clinical evidence that underpins this new therapy.
ReActiv8 — produced by Mainstay Medical, a global medical device company — is a revolutionary device that consists of a small electronic implant designed to interrupt the cycle of low back pain, and is controlled twice daily by the patient. Rather than just covering up symptoms, ReActiv8 addresses the underlying cause of back pain by improving the function of the multifidus muscle.
Dr Thomson explains: “Often, those of us who treat pain are criticised by colleagues for not having the sort of copper-bottomed evidence base; but with this, we are doing really well. We have conducted a sham-controlled randomised study. We also have a new clinical effectiveness study coming out, which will look at using the ReActiv8 therapy in conjunction with the current standard of care, versus the current standard of care alone.”
When the pain becomes chronic and persists,
palliative treatments such as targeted injections
or radiofrequency ablations are frequently used.
Lasting pain and treatment options
Multifidus dysfunction usually stems from some sort of overload on the back, such as lifting something heavy or a flexion-extension injury. Dr Thomson explains that while back pain itself is very common and most people get over an episode, some end up with chronic pain that lasts for six months or more.
Current standard-of-care treatments consist of conservative options such as pain medication and physiotherapy. However, when the pain becomes chronic and persists, palliative treatments such as targeted injections or radiofrequency ablations are frequently used. Unfortunately, these treatments often do not provide lasting relief and require repeat interventions over short periods of time.
Reducing the burden of pain
From a societal economic point of view, the costs of healthcare burden are significant. Moreover, time taken off work by patients, as well as mental health impacts and effects on families, are substantial.