Historical Perspective
History of Medical Electricity for Pain
Modern use of neuromodulation in medicine is firmly related to the postulated pain gate theory by Melzack and Wall in 1965. The same year they used the first peripheral neuromodulation application followed by the first implantation of dorsal column stimulation which is now called spinal cord stimulation. The first peripheral implant was carried out in 1967 followed by the very continuous growth in popularity, indications and of course effectiveness of this treatment. Peripheral neurostimulation was carried out exclusively for surgical implantations until 1999 when the first percutaneous insertion of peripheral leads took place by Weiner and Reid. Since the beginning of this century there has been an enormous expansion of the various indications and techniques of neuromodulation and specifically its peripheral branch.
Cutaneous stimulation is not new. It has been practised with various modifications in the 18th, 19th and 20th centuries however modern applications of cutaneous stimulation started with the introduction of transcutaneous electrical nerve stimulation. This method is very popular but only moderately effective for various types of pain.
Recent Discoveries and Developments
The introduction of a low frequency nerve locating device in the treatment of mainly neuropathic pain by Dr Teodor Goroszeniuk at St Thomas’ Hospital, London in 2002 created new exciting possibilities. Initially devices not built for neuromodulation treatments were used with quite good results in various applications but mainly in the treatment of neuropathic pain. Applications of low frequency electrical fields in the treatment of neuropathic pain is gaining popularity and is currently in use in multiple centres in the UK, Europe and further afield. The Remedius team are dedicated to the design and production of external neuromodulation devices and multiple accessories related to the treatment of pain and improvement of function. The designs range from special physician led multifunctional units to smaller devices permitting patients to use them at home for self-administration. Accessories to those devices are very attractive and can range from single to multi electrode leads for treatment of various painful conditions in single nerve distribution or plexus distributions or even so-called target field applications including facial pains, occipital neuralgia or headache.
