Electrical stimulator for the treatment of back pain and methods of use
Apparatus and methods for treating back pain are provided, in which an implantable stimulator is configured to communicate with an external control system, the implantable stimulator providing a neuromuscular electrical stimulation therapy designed to cause muscle contraction to rehabilitate the muscle, restore neural drive and restore spinal stability; the implantable stimulator further including one or more of a number of additional therapeutic modalities, including a module that provides analgesic stimulation; a module that monitors muscle performance and adjusts the muscle stimulation regime; and/or a module that provides longer term pain relief by selectively and repeatedly ablating nerve fibers. In an alternative embodiment, a standalone implantable RF ablation system is described.
1. A method for treating back pain, the method comprising:
providing at least one electrode disposed on a distal region of a lead, the lead comprising a coiled structure, the distal region configured to be placed within a human such that the at least one electrode is positioned to stimulate efferent motor nerve fibers innervating a multifidus muscle supporting spinal stability of the human, the lead comprising at least one fixation anchor at the distal region angled relative to a longitudinal axis of the lead in a deployed state to anchor the lead so that the at least one electrode is positioned to stimulate the efferent motor nerve fibers; and
applying electrical stimulation through the at least one electrode coupled to a pulse generator to stimulate efferent motor nerve fibers innervating the multifidus muscle to cause contraction of the multifidus muscle, thereby alleviating or reducing the back pain of the human, wherein applying the electrical stimulation through the at least one electrode to stimulate the efferent motor nerve fibers innervating the multifidus muscle is performed without targeting stimulation of afferent nerve fibers, and
wherein the lead has a length to extend from the pulse generator to the efferent motor nerve fibers and is sized and shaped such that the at least one electrode is positioned to stimulate the efferent motor nerve fibers innervating the multifidus muscle.
2. The method of claim 1 , wherein applying the electrical stimulation comprises applying the electrical stimulation through the at least one electrode at a stimulation rate selected from a range of 12-30 Hz.
3. The method of claim 1 , wherein applying the electrical stimulation is performed automatically responsive to an electrical stimulation regime programmed in the pulse generator coupled to the at least one electrode.
4. The method of claim 1 , wherein the at least one electrode comprises a plurality of electrodes.
5. The method of claim 1 , wherein applying the electrical stimulation comprises applying the electrical stimulation through the at least one electrode at a stimulation rate selected from a range of 12-30 Hz to improve neural drive.
6. The method of claim 1 , wherein applying the electrical stimulation through the at least one electrode stimulates the efferent nervous tissue to cause muscle contractions during a predetermined number of sessions.
7. The method of claim 6 , wherein the predetermined number of sessions is over a period of weeks.
8. The method of claim 1 , wherein the pulse applying the electrical stimulation through the at least one electrode stimulates the efferent nervous tissue at an amplitude selected from less than 50 mA.
9. The method of claim 1 , wherein the at least one electrode comprises a first electrode and a second electrode, and
wherein the applying the electrical stimulation comprises applying the electrical stimulation through the first electrode and the second electrode simultaneously.
10. The method of claim 1 , wherein the at least one electrode comprises a first electrode and a second electrode, and
wherein the applying the electrical stimulation comprises applying the electrical stimulation through the first electrode and the second electrode in a time-wise interleaved manner.
11. The method of claim 1 , further comprising an additional electrode lead configured to be coupled to a pulse generator.
12. The method of claim 1 , wherein the at least one fixation anchor is at a distal tip of the lead, the at least one fixation anchor angled proximally relative to the longitudinal axis of the lead in the deployed state.
13. The method of claim 12 , wherein the at least one fixation anchor consists of a single fixation anchor.
14. The method of claim 12 , wherein the at least one fixation anchor is at least one barb.
15. The method of claim 1 , wherein the lead is formed from flexible metal and an outer polymeric cover.
16. The method of claim 1 , further comprising programming the pulse generator with a circuitry module to apply the electrical stimulation through the at least one electrode to stimulate the efferent motor nerve fibers, and
wherein the pulse generator is configured to be programmed with at least one additional circuitry module for additional therapeutic modalities.
17. The method of claim 16 , wherein the pulse generator is configured to be implanted.
18. The system method of claim 17 , wherein the pulse generator is configured to be programmed to transmit data associated with the pulse generator to an external control system.
19. The method of claim 18 , wherein the pulse generator is configured to receive power from the external control system to charge a battery of the pulse generator.
20. The method of claim 16 , wherein the pulse generator is configured to be programmed to transmit data associated with the pulse generator to a computer running monitoring and control software.