What exactly is neurostimulation and what role does manual therapy play in it? According to Advanced Pain Management, a clinic specializing in the implantable, reversible pain management system.

What exactly is neurostimulation and what role does manual therapy play in it?

According to Advanced Pain Management, a clinic specializing in the implantable, reversible pain management system, “neurostimulation therapy treatment, also called spinal cord stimulation, is the safe delivery of low voltage electricity to the dorsal column or peripheral nerves. The implantable stimulator device inhibits pain signals before they reach the brain and replaces them with a soothing, tingling sensation (called paresthesia) that covers the specific area where pain is felt.”

While this is considered to be an “invasive” intervention, it’s minimal in the grand scope of the term, and a remarkable advancement in self managed pain therapy for the patients receiving it. With the ever-expanding models of intervention throughout the medical community, these “invasive” models of neurostimulation provide what modern science believes to be a breakthrough in chronic pain management that is merely in the beginning stages of development.

Many patients suffering from chronic, painful conditions who have been treated with these medical miracle devices would agree that they are life-changing. Others, unfortunately, have experienced adverse side effects such as parasthesia, fluctuations in the electrical impulse, or complications at the surgical site and are left still seeking relief.

Rather than making massage therapy in chronic pain management obsolete, these scientific breakthroughs perfectly position our profession to become a vital adjunct to progressive and evolving care.

The role of a manual therapist

As a clinical community of manual therapists, we are well versed in the effects massage has on our clients’ nervous systems. Ranging from down-regulating pain perception to upregulating proprioception, inciting relaxation, or even for a pre-event stimulatory effect, we’ve been using manual methods of communicating with the nervous system for centuries.

In light of the intention behind these implantable devices designed to interrupt the perception of pain, as manual therapists, what tools do we have at our disposal to offer an intervention option with a similar effect? Can we bridge the pain gap between traditional manual therapy and implantable neurostimulation devices? Research in fascial science is suggesting that we can.

If we understand the dynamics of pain perception and we have a clear understanding of the client’s pathology or mechanism of injury, we should consider reaching for options like IASTM tools and stimulatory methods like therapy balls.

The concept of interrupting the pain response begs us to revisit the primal reaction of rubbing our knee vigorously right after we fall on it, or our elbow after we bang it on something because we know it’s going to hurt. We instinctively introduce distracting signals to our nervous system to disrupt the experience of pain.

If implantable medical devices are employing low voltage electricity to disrupt the sensation of pain, it stands to reason that we are also able to produce similar results by utilizing clinical tools to create the same nervous system interruptions to pain perception. A study found in the Journal of Physical Therapy reviews titled “The Effects of instrument assisted soft tissue mobilization compared to other interventions on pain and function; a systematic review” {Volume 22, 2017-Issue 1-2} concluded “it is suggested that IASTM is an effective treatment intervention for reducing pain and improving function in less than a three-month period.”

Becoming familiar with how to incorporate these methods into your sessions with a chronic pain patient could drastically contribute to the client’s success rate regarding the alleviation of pain.

Today, we have a thorough cadre of education and tools to incorporate at our disposal. As a manual therapist, I’ve accumulated a diverse arsenal of pain management tools myself, ranging from spiky balls, kinesiology tape, and topical analgesics, to a couple sets of IASTM tools with multiple treatment edges and attachments.

If we can reduce the experience of pain by learning how our nervous system transmits that information to the brain and incorporate proven methods to interrupt it, we have the opportunity to provide some relief to our client. Working in conjunction with the primary physician (of a client who is a candidate for, or already has a neurostimulator installed) offers the possibility of providing a collaborative effort for the progression of the client’s wellness.

With new pain science constantly influencing how we see and treat our client’s conditions, we have the opportunity to be a critical factor in our client’s well-being.

About the Author

IASTM stands for Instrument Assisted Soft Tissue Mobilization, otherwise known as a viable and valuable treatment method to add to our toolbox.

Stacey Thomas, L.M.T., S.F.M.A., F.M.S., N.K.T., C.F.-L2, has been dedicated to human movement and athletic performance since 1997 and certified as a sports massage therapist since 2005. She holds certification in Functional Movement Screen, Selective Functional Movement Assessment, Neurokinetic Therapy and CrossFit Level 2, as well as other training and soft tissue modalities. She is credentialed by educational organizations regarding human movement and soft tissue treatment. You can find her in one of her three Front Range, Coloado, clinics treating athletes or teaching courses for RockTape.

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