Systems and methods for the treatment of pain through neural fiber stimulation
Embodiments of the present invention provide systems and methods for the treatment of pain through activation of select neural fibers. The neural fibers may comprise one or more afferent neural fibers and/or one or more efferent neural fibers. If afferent fibers are stimulated, alone or in combination with efferent fibers, a therapeutically effective amount of electrical stimulation is applied to activate afferent pathways in a manner approximating natural afferent activity. The afferent fibers may be associated with primary receptors of muscle spindles, golgi tendon organs, secondary receptors of muscle spindles, joint receptors, touch receptors, and other types of mechanoreceptors and/or proprioceptors. If efferent fibers are stimulated, alone or in combination with afferent fibers, a therapeutically effective amount of electrical stimulation is applied to activate intrafusal and/or extrafusal muscle fibers, which results in an indirect activation of afferent fibers associated therewith.
1. A method comprising:
positioning a lead comprising an electrode, wherein the electrode is at a therapeutically effective distance from a target efferent nerve fiber; and
electrically stimulating through the electrode the target efferent nerve fiber to induce an action potential in the target efferent nerve fiber while avoiding generation of action potentials in a non-target nerve fiber, wherein the target efferent nerve fiber is neurologically upstream from a perceived point of pain, wherein the therapeutically effective distance is greater than 1 mm from the target efferent nerve fiber.
2. The method of claim 1 , wherein the electrode is a single contact electrode.
3. The method of claim 2 , wherein the lead is a helically coiled percutaneous lead.
4. The method of claim 3 , wherein the step of electrically stimulating is performed by an electrical stimulation device.
5. The method of claim 4 , wherein the electrical stimulation device is attached to an external part of a body of a patient.
6. The method of claim 1 , wherein the electrical stimulation is applied for a treatment time to relieve pain.
7. The method of claim 6 , wherein after the treatment time pain to relieve pain is maintained for a period of time, such period of time being at least 17 times the treatment time.
8. The method of claim 1 , wherein inducing the action potential in the target efferent nerve fiber causes a contraction of muscle.
9. The method of claim 1 , wherein the electrically stimulating comprises an electrical stimulation having an amplitude of 20 mA, a frequency of 12 Hz and a pulse duration of 20 μsec.
10. The method of claim 1 , wherein the electrically stimulating comprises an electrical stimulation having an amplitude of 1 mA, a frequency of 5 Hz and a pulse duration of 20 μsec.
11. The method of claim 1 , wherein the electrically stimulating comprises an electrical stimulation having an amplitude of 20 mA, a frequency of 25 Hz and a pulse duration of 200 μsec.
12. The method of claim 1 , wherein the electrically stimulating comprises an electrical stimulation having a frequency of 1 Hz to 20 kHz.
13. The method of claim 1 , wherein the electrically stimulating comprises an electrical stimulation having a frequency of 1 Hz to 300 Hz.
14. A method comprising:
positioning a lead comprising an electrode, wherein the electrode is at a therapeutically effective distance from a target efferent nerve fiber; and
electrically stimulating through the electrode the target efferent nerve fiber to activate one or more efferent axons causing activation of extrafusal muscle fibers and/or intrafusal muscle fibers while avoiding generation of action potentials in a non-target nerve fiber, wherein the therapeutically effective distance is greater than 1 mm from the target efferent nerve fiber.
15. The method of claim 14 , wherein the electrode is a single contact electrode.
16. The method of claim 15 , wherein the lead is a helically coiled percutaneous lead.
17. The method of claim 16 , wherein the step of electrically stimulating is performed by an electrical stimulation device.
18. The method of claim 17 , wherein the electrical stimulation device is implantable into a body of a patient.
19. The method of claim 14 , wherein the electrically stimulating comprises an electrical stimulation having an amplitude of 20 mA, a frequency of 12 Hz and a pulse duration of 20 μsec.
20. The method of claim 14 , wherein the electrically stimulating comprises an electrical stimulation having an amplitude of 1 mA, a frequency of 5 Hz and a pulse duration of 20 μsec.
21. The method of claim 14 , wherein the electrically stimulating comprises an electrical stimulation having an amplitude of 20 mA, a frequency of 25 Hz and a pulse duration of 200 μsec.
22. The method of claim 14 , wherein the electrically stimulating comprises an electrical stimulation having a frequency of 1 Hz to 20 kHz.
23. The method of claim 14 , wherein the electrically stimulating comprises an electrical stimulation having a frequency of 1 Hz to 300 Hz.
24. A method comprising:
inserting a single contact electrode operatively coupled with a lead in a patient at a therapeutically effective distance from a target efferent nerve fiber;
connecting the lead with an electrical stimulation device; and
electrically stimulating through the electrical stimulation device, the lead and the electrode the target efferent nerve fiber to generate an action potential in the target efferent nerve fiber while avoiding generation of action potentials in a small sensory nerve fiber to generate a reduction of pain in the patient, wherein the therapeutically effective distance is greater than 1 mm from the target efferent nerve fiber.
25. The method of claim 24 , wherein the electrode is a single contact electrode.
26. The method of claim 25 , wherein the lead is a helically coiled percutaneous lead.
27. The method of claim 24 , wherein the step of electrically stimulating is performed by an electrical stimulation device.
28. The method of claim 27 , wherein the electrical stimulation device is implantable into a body of a patient.
29. The method of claim 24 , wherein the electrically stimulating comprises an electrical stimulation having an amplitude of 20 mA, a frequency of 12 Hz and a pulse duration of 20 μsec.
30. The method of claim 24 , wherein the electrically stimulating comprises an electrical stimulation having an amplitude of 1 mA, a frequency of 5 Hz and a pulse duration of 20 μsec.
31. The method of claim 24 , wherein the electrically stimulating comprises an electrical stimulation having an amplitude of 20 mA, a frequency of 25 Hz and a pulse duration of 200 μsec.
32. The method of claim 24 , wherein the electrically stimulating comprises an electrical stimulation having a frequency of 1 Hz to 20 kHz.
33. The method of claim 24 , wherein the electrically stimulating comprises an electrical stimulation having a frequency of 1 Hz to 300 Hz.