Restorative Neurostimulation: A Clinical Guide for Therapy Adoption

In this review, we present a comprehensive clinical approach to restorative neurostimulation, a novel form of stimulation for refractory chronic mechanical low back pain, targeting impaired neuromuscular control and degeneration of the multifidus muscle. We focus on patient identification, technique...

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Bibliographic Details
Published in:Journal of pain research 2022-01, Vol.15, p.1759-1774
Main Authors: Chakravarthy, Krishnan, Lee, David, Tram, Jennifer, Sheth, Samir, Heros, Robert, Manion, Smith, Patel, Vikas, Kiesel, Kyle, Ghandour, Yousef, Gilligan, Christopher
Format: Article
Language:English
Subjects:
arthrogenic inhibition
Back pain
Backache
Care and treatment
chronic mechanical low back pain
Clinical outcomes
multifidus
Nervous system
neuromodulation
neuromuscular control
Pain
Patients
Physical therapy
restorative neurostimulation
Review
Transcranial magnetic stimulation
Ultrasonic imaging
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Summary:In this review, we present a comprehensive clinical approach to restorative neurostimulation, a novel form of stimulation for refractory chronic mechanical low back pain, targeting impaired neuromuscular control and degeneration of the multifidus muscle. We focus on patient identification, technique guidance, and review of the scientific background and clinical evidence. As our understanding of back pain grows, there is clear evidence that impaired neuromuscular control and consequent degeneration of the multifidus muscle contribute to mechanical low back pain development and maintenance. We provide clinical guidance regarding an implantable restorative neurostimulation system that targets impaired neuromuscular control. Supported by results from a randomized, active-sham-controlled clinical trial with long-term follow-up, we provide clinicians with a comprehensive overview and practical clinical guidance for the adoption of this therapy modality. Keywords: restorative neurostimulation, multifidus, arthrogenic inhibition, neuromodulation, chronic mechanical low back pain, neuromuscular control
ISSN:1178-7090
1178-7090
DOI:10.2147/JPR.S364081