Knowing When to Add Neurostimulation to Your Clinical Services Offering


Neurostimulation therapy has been around for several decades, but most patients and even their doctors have very little experience with the treatment option.  While there are many device manufacturers and different treatment strategies, almost all of them consist of a device that generates an electrical impulse that gets delivered to the body through wires that affixed to the body.  The first neurostimulators were surgical implants, but today there are also minimally invasive options that offer flexibility in patient comfort and affordability.   


Patient Selection and Intake


The best candidates for treatment with neurostimulation are patients that report discomfort from neuropathic conditions.  Patients who complain of pain in the lower back and legs, the upper back and arms, the neck are all potential candidates for neurostimulation therapy.  In some cases, even conditions such as migraine headaches may be positively affected.
Psychological factors are also important in patient selection for neurostimulation therapy.  Compliance with treatment protocols is highly correlated with positive outcomes, so those with poor motivation or poor appointment attendance rates may not be good candidates.  
Patients who l still desire an active lifestyle and maintain many social connections are often reticent to use opioid based pain medications due to their side effects.  Treatment with a neurostimulator can offer pain relief without dulling their emotional experience and social interactions.


Contraindications


Certain patients will be less than ideal candidates for neurostimulation treatment. Patients that are already undergoing treatment with other spinal interventions, such as epidurals, are not typically good candidates. Likewise, cancer patients and those with neurological or other conditions that require frequent MRIs will have trouble benefiting from neurostimulation. Some kinds of psychological conditions may make an installed device, impractical, as the electrical leads can be easily dislodged if not treated with care.


That said, patients that still exercise or maintain otherwise active lifestyles may experience difficulty with certain types of neurostimulators – their activities may dislodge the devices or the electrical leads that are affixed to their bodies. While this is not a contraindication, it is important for practicing clinicians to train the patient in proper care of the device and preparation for various kinds of activities.  Failure to do so will result in poor outcomes or an unhappy and dissatisfied patient.  


Conclusion


A number of factors are making neurostimulators an attractive treatment option for medical practices to add to their service offering.  Most importantly, patient demand is high for non-pharmaceutical means of managing pain. Additionally, the investment for the practice to be able to deliver treatment via the latest neurostimulation devices – in training time and equipment – is quite modest.  With some systems, practices may be treatment ready within a month’s time.



 


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