Up to 30% of patients prescribed opioids for pain misuse them, according to the National Institute on Drug Abuse, a division of the National Institutes of Health. Between 8% and 12% of patients who are prescribed opioids develop an addiction. In total, the institute states that 115 people in the United States die every day due to opioid overdoses.
“Given the nationwide emphasis on the opioid crisis, those living with chronic pain feel there is a stigma that comes with seeking out strong pain prescriptions,” says Shai Gozani, MD, PhD, president, CEO, and director of NeuroMetrix, Inc., the company that created Quell, a wearable neurostimulation device. “It's important to provide individuals with long-term pain conditions with enough options to be able to find an effective relief system that works for them.”
Below are some technology solutions on the market that can treat chronic pain, allowing patients to eliminate or decrease their dependence on opioid drugs.
Quell by NeuroMetrix
By using neurostimulation technology to tap into the body’s natural pain response and block pain signals, Quell helps patients with chronic back, arthritic, nerve, leg, and foot pain. The wearable device is FDA-cleared for daytime and overnight use. It is inserted in a cuff that can be positioned on the body and has an accompanying app that helps people track pain management and sleep patterns affected by chronic pain.
A clinical study of 713 Quell users released by the Journal of Pain Research in April 2018 found that 80% reported improvement in their chronic pain and about 66% reported reduction in their pain medication use due to using Quell. On average, study participants used Quell for 35 hours per week.
“Because pain is extremely personal and is experienced differently by all people, those living with chronic pain often need a variety of treatments to find relief—what we call a ‘toolbox approach’ to chronic pain,” Gozani says.
The SPRINT PNS system by SPR Therapeutics
The SPRINT PNS system is designed to treat pain through peripheral nerve stimulation. The single thin, thread-like wire, or lead, is implanted through a needle introducer under ultrasound guidance and is placed approximately 1 centimeter from nerves for stimulation therapy delivery up to 60 days. The system is used to treat post-amputation, lower back, shoulder, and knee replacement pain.
“As a device there are no withdrawal symptoms, and consequently, no drug-related side effects,” says Mark Stultz, senior vice president of market development for SPR Therapeutics. “SPRINT is intended to provide pain relief directly to the nerve where it is needed, whereas opioids are systematic, have significant side effects, and are susceptible to addiction and diversion.”
The system is currently on the market, and the company recently launched its next generation, dual lead system (which allows for more thorough coverage of the pain area), SPRINT extensa PNS system, following FDA approval on July 31.
BreatheVR by Neon
Virtual reality (VR) provides a unique approach to pain management, as studies show that immersive distraction can de-escalate some chronic pain.
BreatheVR is an application available through Samsung Gear VR and Oculus Go headsets that helps patients with deep breathing and meditation exercises to alleviate pain.
Deepa Mann-Kler, founder and CEO of Neon, says a November 2017 pilot study of BreatheVR found that in less than three minutes, 80% of participants reported a de-escalation of pain.
“The biggest drop in pain was 50%, from 7 to 3.5 on the visual analog scale psychometric response pain scale,” Mann-Kler says. “The benefits of deep breathing and meditation have long been recognized as aiding relaxation. Recent studies using virtual reality also evidence further benefits. BreatheVR combines the power of virtual reality and deep breathing to create a uniquely immersive user experience.”
The BreatheVR application engages users in an animated meadow, by having them listen to music and birds. The user is asked to inhale and exhale, and as their breath is detected by the headset’s microphone, leaves in the virtual reality environment move. This sequence is then repeated, encouraging the user to get into a pattern of diaphragmatic breathing.
Mann-Kler says there are more than 100 active users of the application and the company is compiling use cases from fibromyalgia patients who are using BreatheVR at home.
“We have not fully explored VR’s capabilities yet,” Mann-Kler says. “When we can truly personalize the experience for each person through the use of full sensory and biodata feedback loops, we will actually be meeting each person’s needs on an individual basis.”
StimRouter by Bioness
This long-term pain solution treats chronic nerve pain through peripheral nerve stimulation. It has been used on 24 different peripheral nerves since launching in 2016. The device is 15 centimeters and “feels like a limp piece of spaghetti,” says Mark Geiger, global director of marketing implantables at Bioness, the company that produces StimRouter.
“By stimulating the target peripheral nerve with a small amount of energy that feels like a gentle tingling sensation, the nerve cannot communicate a pain signal. Over time, this stimulation may cause the nerve to perform more normally,” Geiger says. “So, the difference is targeted pain management at the source of the pain compared to global pain reduction with an oral or IV pain medication with all the typical, sometimes deleterious side effects.”
The StimRouter is implanted through the skin, while the patient is under local anesthesia. According to Geiger, patients can provide feedback to the physician implanting the device immediately.
“The StimRouter is a permanent solution meant to last a lifetime. In many cases, based on many hundreds of implants, patients use the StimRouter for shorter durations over time with increasing carry-over pain relief, meaning the pain relief lasts for hours/days after the StimRouter is shut off by the patient,” Geiger says.
Donna Marbury is a writer in Columbus, Ohio.