All About Neuromodulation and Muscle Restoration Therapy

Traditional modalities to treat pain originating from the spine involve medications, physical therapy/chiropractic treatment, interventional pain management procedures, and surgical intervention. However, an array of procedures can be performed under the neuromodulation category that can afford patients a better treatment option to treat their spine-related pain. 

Neuromodulation is a medical technique that involves the alteration or regulation of the nervous system’s activity using various methods and devices. It is often used in the context of chronic pain management. Neuromodulation techniques aim to modify or influence the nervous system’s functioning to reduce or control pain, among other conditions. Dr. Ali H. Mesiwala utilizes neuromodulation technologies and therapies to augment and treat patients suffering from chronic pain. 

The various neuromodulation techniques and technologies are designed to help patients manage chronic pain when other treatments, such as medications or physical therapy, have proven ineffective or insufficient. They offer alternative approaches to pain management and can significantly improve the quality of life for individuals suffering from chronic pain. Patients considering these treatments should consult with a healthcare provider to determine the most appropriate option for their specific condition.

Here are some general criteria that healthcare providers may use to identify candidates for neuromodulation for chronic or atypical back pain: 

1. Diagnosis: Patients should have a clear and specific diagnosis of their pain condition. This may include conditions such as failed back surgery syndrome, complex, regional pain syndrome (CRPS), neuropathic pain, or other chronic pain conditions confirmed through clinical evaluation, imaging, and diagnostic tests. 
2. Failed Conventional Treatments: Candidates should have tried and failed to achieve adequate pain relief through traditional treatments like medications, physical therapy, and non-invasive interventions. The pain often persists or worsens despite these efforts. 
3. Psychological Evaluation: Patients undergoing neuromodulation are typically required to undergo a psychological evaluation to assess the patient’s mental health and emotional well-being, as psychological factors can play a role in chronic pain. 
4. Trial Stimulation: Sometimes a trial stimulation may be conducted. During the trial temporary leads or electrodes are placed near the spinal nerve(s)/cord and connected to an external generator (battery). If the patient experiences significant pain relief during the trials, they may proceed with permanent implantation. 

Some of the various types of neuromodulation technologies that Dr. Ali Mesiwala utilizes to treat his patients include: 

• Spinal Cord Stimulator (SCS): Spinal cord stimulators are implantable electrodes that run on top of or parallel to the spinal cord deliver an electrical impulse to the spinal cord and disrupt the pain signals from ascending. 
• Dorsal Root Ganglion Stimulator (DRG): This stimulator is a technique that targets specific nerve bundles in the spine called dorsal root ganglia. It is used to treat chronic pain and more often complex regional pain syndrome. 
• Peripheral Nerve Stimulator (PNS): Similar to spinal cord stimulators, peripheral nerve stimulators are implantable electrodes that run parallel to peripheral nerves for the management of pain in specific areas of the body. 
• ReActiv8 Muscle Regenerative Therapy: This one-of-a-kind system, utilizes tiny electrodes implanted into a muscle in the lower back and connected to a generator, typically placed in the flank, to help stimulate and strengthen muscles in the lower back. This in turn leads to muscle regeneration and helps to alleviate atypical back pain and improve physical function. 

After a comprehensive workup and diagnosis, Dr. Ali Mesiwala can perform the operation to implant these systems in under an hour in the outpatient setting. After undergoing the procedure at a surgery center, patients go home the same day and work with their clinical representative to optimize their settings.  Dr. Ali Mesiwala regularly follows up with his patients to ensure that they are progressing in the right direction to an active lifestyle. 

It’s important to note that the decision to use neuromodulation for chronic or atypical back pain is highly individualized. Patients should have a thorough evaluation and discussion with their healthcare provider, including pain specialists and neurosurgeons to determine if they are suitable candidates for these procedures. Additionally, the specific type of neuromodulation and the choice of device will depend on the patient’s diagnosis and needs. 

Board Certified Neurosurgeon, Dr. Ali H. Mesiwala offers this array of neuromodulation technologies to offer comprehensive treatment of his patients’ spinal ailments and pain. He is dedicated to  understanding how much pain can truly impact your ability to function on a daily basis and takes the time to listen and understand his patient’s needs. Dr. Mesiwala is also the faculty for these procedures, meaning he trains other surgeons on the procedures and also participates in the research and development of these technologies. 

If you or a loved one suffer from chronic back pain, think you may be a candidate, or want to learn please visit our website to set up a consultation with Dr. Mesiwala at one of his locations in Newport Beach, Marina del Rey, and Rancho Cucamonga.