Treating Chronic Low Back Pain Effectively with BioWave High Frequency Peripheral Nerve Stimulation

Introduction

The founder and president of Biowave, Brad Siff, welcomes the audience to the second webinar. He introduces Dr. Dominic Hegarty as the guest lecturer who will discuss how Biowave can be used to treat chronic low back pain.

About Dr. Dominic Hegarty

Dr. Dominic Hegarty is introduced as the President-elect of the World Institute of Pain and a consultant in pain management and neuromodulation at Mater Private Hospital in Cork.

Agenda for the Webinar

The webinar will focus on three key areas: etiology of persistent low back pain, a case study example, and new ideas on how Biowave technology can be used to treat chronic low back pain.

Importance of Treating Chronic Low Back Pain

Chronic low back pain is a significant issue globally, with millions being spent on it regularly across Europe alone. It has a massive impact on healthcare systems, labor productivity, and people's ability to work.

Struggles in Managing Chronic Low Back Pain

Clinicians struggle to manage chronic low back pain effectively despite its prevalence. Dr. Hegarty sees many patients with this condition in his clinical practice in Ireland.

Three Key Areas for Discussion

Dr. Hegarty outlines three key areas he will cover during the webinar: etiology of persistent low back pain, a case study example, and new ideas on how Biowave technology can be used to treat chronic low back pain.

Etiology of Persistent Low Back Pain

• Chronic low back pain is caused by various factors such as degenerative disc disease, spinal stenosis, and failed back surgery syndrome.

• Understanding the cause of chronic low back pain is crucial in determining how to treat it effectively.

Case Study Example

• Dr. Hegarty presents a case study example of a patient with chronic low back pain who was treated with Biowave technology.

• The patient experienced significant pain relief after using Biowave technology for several weeks.

New Ideas on How Biowave Technology Can Be Used to Treat Chronic Low Back Pain

• Biowave technology is a new option for treating chronic low back pain that can be used in conjunction with other treatments.

• It works by blocking pain signals from reaching the brain, providing long-lasting pain relief without the use of drugs or surgery.

• Biowave technology has been shown to be effective in treating various types of chronic pain, including low back pain.

Low Back Pain Assessment and Treatment

In this section, the speaker discusses the standard filter used to assess low back pain and the initial conservative treatment strategies that are employed. They also discuss advanced treatment strategies that may be necessary if conservative treatments fail.

The Standard Filter for Low Back Pain Assessment

• When an individual presents with low back pain, a standard filter is used to ensure red flags are not missed.

• Conservative strategies such as analgesics and rehabilitation are initially employed.

• Advanced strategies become necessary if low back pain persists beyond three to five months.

Understanding Chronic Low Back Pain

• Chronic low back pain can result from various factors such as muscle, ligament, tendon, disc or nerve fiber issues.

• Interventionists look at different areas such as facet joints, disc tissue, tendons and muscles when treating chronic low back pain.

• Muscle strategy is often overlooked but plays a significant role in managing chronic low back pain.

Case Study: Mid 40's Male with Persistent Low Back Pain

• A case study of a mid 40's male with persistent low back pain aggravated by working from home due to prolonged sitting in front of his computer.

• Atrophy of muscle groups can occur even if there are other underlying issues causing chronic low back pain.

• Muscle strengthening is crucial but often difficult to manage when an individual is sore and in pain.

Sleep Difficulties and Pain Management

In this section, the speaker discusses how chronic pain affects an individual's sleep and overall well-being. They also mention the impact of medication costs and failed treatments.

Impact of Chronic Pain on Sleep

• Individuals with chronic pain have difficulty recovering, which impacts their ability to do activities.

• They may be able to do some activities but recover very slowly.

• Poor sleep is a common issue for individuals with chronic pain, impacting their overall wellness.

Failed Treatments and Medication Costs

• Most individuals with chronic pain have gone through various medications that have failed or are taking them because they don't have any other choice.

• This is not the best care practice as it leads to medication costs that they don't want to spend money on.

• Physiotherapy or rehab may plateau if they're unable to get over the pain or lack motivation.

Interventional vs. Biowave Clinic

• The speaker tries to identify if there's an interventional aspect that can contribute to an individual's situation.

• If not, they divert them into a biowave clinic where a technical person educates them about using the device.

• The biowave clinic uses a 30-minute window for treatment and encourages individuals to start using it immediately.

Positive Feedback from Biowave Clinic

• By following up at around day 10 to 14, three out of four individuals find the device useful and adapt well to it.

• By the 12-week mark, most individuals are still using the device and finding it helpful in managing their pain without high costs or energy impact.

Directing the Use of Electrical Stimulation

In this section, the speaker discusses how they direct patients to use electrical stimulation for pain relief. They explain that patients are shown a diagram and directed to stimulate the lower back where they feel pain. The device provides immediate feedback, allowing patients to target their source of pain.

Flexibility in Stimulating Muscle Tissue

• Clinicians have flexibility in moving the device up and down or left and right to impact muscle tissue.

• Patients can target their source of pain with the device, leading to positive feedback.

• Patients experience less pain, with scores falling below three on a scale of zero to ten.

Improved Recovery Period and Quality of Life

• Patients experience improved recovery periods, allowing them to do more activities without paying the price for it.

• Sleep patterns improve, leading to better quality of life over time.

• Mood, activity levels, and anxiety all improve as well.

Positive Feedback from Patients

In this section, the speaker discusses how patients respond positively to using electrical stimulation for pain relief. They mention that patients compare it favorably to taking medication and appreciate not having to rely on tablets.

Automatic Buy-In from Patients

• Patients tend not to want to take medication and appreciate anything that allows them not to rely on tablets.

• There is an automatic buy-in from patients who are happy with their results.

Clinical Impact of Electrical Stimulation

In this section, the speaker presents data showing the clinical impact of using electrical stimulation for chronic low back pain. They explain that the impact size and p-value meet expectations, indicating that the model is working.

Clinical Impact of Electrical Stimulation

• Data shows that using electrical stimulation for chronic low back pain has a clinical impact.

• The impact size and p-value meet expectations, indicating that the model is working.

• Using electrical stimulation frees up space for more advanced procedures.

Formulating the Design of the Clinic

In this section, the speaker talks about a paper that helped formulate the design of the clinic and suggests reading it to gain a better understanding of their work.

Paper on Cohort of Patients

• The speaker suggests reading a paper that helped formulate the design of the clinic.

• The paper includes over 600 patients and may have a cohort that matches one's practice.

Why Biowave Works

In this section, the speaker explains why they believe Biowave works and discusses some key points related to tissue morphology and nerve fibers.

Tissue Morphology and Nerve Fibers

• Biowave is not just another blue box with two stickies placed on one's back; there is science behind it.

• Electrical energy generated by devices like Biowave can penetrate tissue and nerve fibers.

• Two types of tissue matter: muscle tissue with nociceptors (pain receptors) and peripheral nerve tissue.

Receptors in Muscle Tissue

• Nociceptors in muscle tissue are designed to pick up when we hurt or injure ourselves, particularly for muscle injuries such as strains or pulls.

• Feedback from these fibers feeds into joints, somatic elements, and skin features such as paresthesia or numbness.

Sodium Channels

• Voltage-gated sodium channels (NaV1.8 and NaV1.9) play a key role in pain pathways, influencing pain perception when influenced by local anesthetics or toxins in animal models.

• Biowave generates an electrical field that reaches into these areas and impacts them, influencing pain pathways.

Free Nerve Endings

• Although free nerve endings lack the receptive structure associated with pressure receptors, they are still receptors that carry messages in one format transferred into electrical activity and passed to the brain.

• They are not free but quite lined, wrapped around by Schwann cells with little windows in the fibers themselves that allow them to sample the area and test the tissue they're in.

Neural Activity and Peripheral Nerve Fibers

The transcript discusses the role of increased neural activity in tissues that produce serotonin and bradykinin, which influence nerve pathways. It also highlights the importance of peripheral nerve fibers in transmitting signals to the brain.

Increased Neural Activity

• Tissues that produce serotonin and bradykinin have receptors for them, which can influence nerve pathways.

Peripheral Nerve Fibers

• Sodium channels play a crucial role in transmitting signals from tissue endings to the brain.

• Biowave has an impact on peripheral nerves because it can penetrate deep enough into muscle tissue to stop activity occurring at its base.

• Different types of sodium channels are important in different stages of action potentials, with navi 1.9 keeping the threshold level and navy 1.8 contributing to the upswing or up phase of action potential.

• Electrical activity can counterbalance pain signals by penetrating deep enough into muscle tissue to stop activity occurring at its base, providing persistent relief from pain.

Impact of Biowave on Pain Relief

This section focuses on how biowave impacts pain relief through its effect on nerve fibers.

Biowave's Effect on Nerve Fibers

• Biowave reaches into tissues and has an impact on nerve fibers, leading to clinical improvements in pain relief that persist over time.

• Individuals continue using biowave because they get many hours of relief from it due to their maintained level of nerve fiber firing.

Comparison with TENS Machine

In this section, the speaker compares the biowave device to a TENS machine and explains why the biowave is more effective in treating chronic low back pain.

Differences between Biowave and TENS Machine

• The biowave device can influence sodium channels and neural inflammatory mediator pathways, while the TENS machine only stays on the surface of muscles.

• The TENS machine can actually contract sore muscles, which can worsen injuries.

• The biowave device has the ability to switch between different frequencies and impact pain pathways effectively.

Importance of Biowave for Chronic Low Back Pain Patients

In this section, the speaker discusses how the biowave device can be valuable for chronic low back pain patients who may not have access to other treatments.

Benefits of Biowave for Chronic Low Back Pain Patients

• Chronic low back pain affects a large number of individuals who may not have access to pain services or interventions.

• The biowave device offers accessibility, non-invasiveness, drug-free treatment, and user-friendliness.

• Conservative strategies like using the biowave device can be used to stop chronic low back pain from progressing further.

Clinical Input and Future Opportunities

In this section, the speaker emphasizes that clinical input is important when using the biowave device and discusses future opportunities for its use.

Importance of Clinical Input

• Advising people on how to use it properly is important because understanding nerve pathways where ideal pad placement should be and how to get at them makes a difference.

• Clinical input is important when using the biowave device, and it should not be handed out without proper guidance.

Future Opportunities

• The biowave device can help reduce day-to-day waiting lists for chronic low back pain patients in public health services.

• Reimbursement strategies are needed to ensure that the biowave device is accessible and not limited by costs.

Drug-Free Interventional Solutions for Pain Management

In this section, the speaker discusses the importance of drug-free intervention and practical solutions for pain management.

Using Biowave for Pain Management

• The speaker shares his experience using Biowave as a clinical tool for pain management.

• He highlights the need for quality studies to compare the device's effectiveness and economic benefits.

• The speaker emphasizes that Biowave is a clinical tool that can benefit individuals with chronic pain.

• He answers common questions about where to place the pads on the lower back area and how to adjust them based on individual needs.

• The depth of Biowave waves reaches about four or five centimeters, making it effective in treating muscle groups in the lower back area.

• The speaker recommends conducting trial runs in a clinic setting to ensure proper placement of pads and encourage patients to use them at home.

Using Different Pads with Biowave

• There are different types of pads available, including B-type and pad systems that are approximately four to five centimeters in diameter.

• The speaker recommends using different pads based on individual needs but does not provide specific details.

Q&A Session

• Participants asked questions about how often to use different pads, how long each session should last, and whether there are any side effects.

• The speaker provides general recommendations but emphasizes that individual needs may vary.

Biowave Device Overview

In this section, the speaker provides an overview of the Biowave device and its usage.

Usage and Availability of Pads

• The pads supplied with the Biowave device are sufficient for most individuals who will use the device at home.

• Three pads with three packs would easily get you over a month's supply.

• It is not heavy on consumables, which is an important aspect to consider.

Frequency of Use

• The device can be used as often as individuals like, but it is recommended to use it twice a day or perhaps three times initially.

• As individuals improve, they find that they need to commit less time to treatment.

• It is practical to use in the late afternoon or evening time because individuals are more likely to benefit from it and get a good night's rest from it.

Contraindications

• The Biowave device has no contraindications for cancer patients or those with a history of cancer. It can even be used by individuals who have metastatic disease low back pain related to itself.

Cumulative Effect

• Regular use of the Biowave device over a continued period shows cumulative benefits in patients, including using it less frequently as they improve and getting longer out of each patch system.

Biowave as a Tool for Treating Back Pain

In this section, the speaker discusses how Biowave can be used to treat back pain and improve tissue health. They also mention the importance of regular use and follow-up appointments.

Biowave's Effect on Tissue Health

• Biowave influences tissue health by changing the sensitivity of nerve fibers and allowing for healing.

• Lack of pain encourages movement, which is important for recovery from back pain.

• Regular use of Biowave can extend the recovery period and soften any discomfort associated with activity.

Importance of Regular Use and Follow-Up Appointments

• A two-week window is a deliberate time frame that allows people to get familiar with using Biowave properly.

• People who have used Biowave report it being better than medication or physiotherapy strategies.

• Regular use of Biowave eliminates the need for frequent physiotherapy sessions, saving individuals time and money.

Using Biowave to Treat Pelvic Floor Pain

In this section, the speakers discuss how Biowave can be used to treat pelvic floor pain. They caution against using it without proper experience or familiarity with its use.

Treating Pelvic Floor Pain with Biowave

• There is substantial anecdotal evidence in the US supporting the use of Biowave to treat interstitial pain resulting from interstitial cystitis.

• Electrodes can be placed in the groin area over the pubis or a bilateral sacral treatment can be done to capture the sacral nerves.

• Biowave can be used to treat pelvic floor pain, but it is important to have experience and familiarity with its use before attempting to do so.

Introduction to Pain Management

In this section, the speakers discuss the usefulness of pain management and how it can target nerves to make a big impact on pain. They also mention that pain management offers flexibility and controls many variables.

Benefits of Pain Management

• Pain management is a great option for individuals who want something they can manage without being in the hospital.

• It offers more than just pain relief; it also provides flexibility and controls many variables.

Percutaneous Electrodes vs Non-Invasive Electrodes

• Percutaneous electrodes are micro needle patch technology that bypasses the impedance of the skin, allowing signals to pass more easily into deeper tissue.

• Physicians in the US might choose percutaneous electrodes when they need deeper penetration of the active electrical field inside the body or if they're targeting nerves deeper inside the body.

• If someone has high impedance skin, using percutaneous electrodes could make a difference between having a more substantial clinical effect than not.

Use Cases for Percutaneous Electrodes

• The speakers use percutaneous electrodes in individuals who are on their way down from procedures such as facet innervation or injection to the facet territory themselves.

• They use it as a targeted strategy to stay on top of patients with underlying issues who may not want another procedure or are struggling with physiotherapy.

• The standard B-type pads are used initially, but if feedback is not as expected, then percutaneous electrodes may be used for deeper penetration and better sensation.

Differences Between Pads

• Both types of pads can mimic each other's effects, but you need more percentage drive on your biowave on-the-go version than on larger pads because you're getting beyond resistance and penetrating deeper.

Role of Percutaneous Pads

The speaker discusses the role of percutaneous pads in pain management.

Use of Percutaneous Pads

• Percutaneous pads have a role in pain management.

• They are clinician-driven and not given out to individuals going home.

• Sensible use is required, and it is important to know who they are being used with.

Using Biowave in Treatment Protocol

The speaker discusses the use of Biowave in treatment protocols.

When to Use Biowave

• Biowave can be used when there is an element of doubt or if the individual is on moderate to mid-range oral analgesia.

• It can be used as a conservative lean-out point before stepping up treatment after two to three weeks.

• It helps individuals avoid getting into the hospital environment and can be followed up with technical support.

Benefits of Using Biowave

The speaker discusses the benefits of using Biowave for pain management.

Benefits of Using Biowave

• It can be very effective for areas that are irritating and have a nerve pattern.

• It avoids injections, pulsed innovation denervation strategies, etc.

• It helps move people through the pathway and get the flow going easier.

Conclusion

The speaker concludes the webinar by thanking attendees and inviting them to send any questions they may have.

Conclusion

• This was a monthly webinar on different subject matters.

• Attendees were invited to send any questions they may have via email.