Chronic pain sufferers know the life-limitations they endure on a daily basis. When long-term medication management appears to be the only option available, life itself seems hopeless and Non-Surgical Medical is now offering an innovative procedure called Neuromodulation for this group. Below is a press release about the details of the procedure:
Frequently Asked Questions About Neuromodulation (rTMS)
Why does rTMS (AKA: Neuromodulation) work?
Repetitive Transcranial Magnetic Stimulation (rTMS), also known as Neuromodulation, has been shown to produce changes in neuronal activity in regions of the brain implicated in chronic pain and mood regulation. Such areas of the brain include the motor cortex and the prefrontal cortex. As each magnetic pulse passes through the skull and into the brain, this induces brief activity of the brain cells underlying the Neuromodulation treatment coil.
The frequency of pulse delivery also influences whether brain activity is increased or decreased by a session of Neuromodulation. Recent studies indicate best outcomes for chronic pain and depression require treatment at higher frequency (greater than 5 Hertz) to respond favorably. At NonSurgical Medical Group, we perform the Neuromodulation (rTMS) procedure at a frequency of 10 Hertz (deemed to be the optimal frequency by nearly all chronic pain clinical studies).
When is Neuromodulation (rTMS) used?
Patients who have failed to achieve an adequate response from pain medications, antidepressants, or who are unable to tolerate medications for their respective condition, might consider Neuromodulation (rTMS) therapy.
What happens during a Neuromodulation (rTMS) procedure?
Because Neuromodulation (rTMS) uses magnetic pulses, before beginning a treatment, patients are asked to remove any magnetic-sensitive objects (such as jewelry, credit cards). Patients are required to wear earplugs during treatment for their comfort and hearing protection, as Neuromodulation (rTMS) produces a loud clicking sound with each pulse, much like an MRI machine. Patients are seated in a reclined position during each session of Neuromodulation (rTMS).
During the first Neuromodulation (rTMS) session, several measurements are made to ensure that the TMS coil will be properly positioned over the patient’s head. Once this is done, the TMS coil is comfortably suspended over the patient’s scalp using an articulation arm. The TMS physician works with his TMS technician to measure the patient’s motor threshold, by administering several brief pulses. The motor threshold is the minimum amount of power necessary to make the patient’s thumb twitch, and varies from individual to individual. Measuring the motor threshold helps the physician personalize the treatment settings and determine the amount of energy required to stimulate brain cells.
Once the motor threshold is determined, the coil is then positioned so that it rests above the appropriate region of the patient’s brain. Treatment is then commenced. During the treatment, patients will hear a series of clicking sounds and will feel a tapping sensation under the treatment coil.
Motor threshold is not checked at every treatment but may be reassessed if there is concern it could have changed, for example, because of a change in medication.
Who administers Neuromodulation (rTMS)?
Neuromodulation (rTMS) is always prescribed and the initial motor threshold is always confirmed by a TMS physician. The treatment itself is administered by an experienced TMS technician under the supervision of the TMS physician or by the TMS physician.
The TMS technician or physician will always be present to monitor the patient during the treatment. The patient can stop a treatment at any time by asking the staff member present.
How long is a Neuromodulation (rTMS) procedure?
Neuromodulation (rTMS) therapy involves a series of treatment sessions. Treatment sessions vary in length depending on the TMS coil used and the number of pulses delivered but typically last around 15 – 37 minutes. Patients receive TMS 5 days a week. A typical course duration of Neuromodulation (rTMS) is 6 weeks. However, this can vary depending on an individual’s response to treatment.
Do I need to be hospitalized for a course of Neuromodulation (rTMS)?
Unlike ECT (Electric Convulsive Therapy), Neuromodulation (rTMS) does not require any sedation or general anesthesia, so patients are fully awake and aware during the treatment. There is no “recovery time”, so patients can drive home afterwards and return to their usual activities.
Is Neuromodulation (rTMS) therapy considered safe?
Yes. Neuromodulation (rTMS) therapy was FDA approved for the treatment of medication resistant major depressive disorder in 2008. The Neuromodulation (rTMS) equipment utilized at NonSurgical Medical Group for the treatment of chronic pain was given FDA 510K Clearance for safety as an equivalent rTMS Class II medical device in December of 2016.
Neuromodulation (rTMS) is well-tolerated and associated with few side-effects and only a small percentage of patients discontinue treatment because of these. The most common side-effect, which is reported in about one-third to half of patients treated with rTMS (about 1 of every 10 sessions), is headaches. These are mild and generally diminish over the course of the treatment. Over-the-counter pain medication can be used to treat these headaches.
About one-third of patients may experience painful scalp sensations or facial twitching with rTMS pulses. These too tend to diminish over the course of treatment although adjustments can be made immediately in coil positioning and stimulation settings to reduce discomfort.
The Neuromodulation (rTMS) machine produces a loud noise and because of this, earplugs are given to the patient to use during the treatment. However, some patients may still complain of hearing problems immediately following treatment. No evidence suggests these effects are permanent if earplugs are worn during the treatment.
Neuromodulation (rTMS) has NOT been associated with many of the side-effects caused by pain medication, such as constipation, drowsiness, and nausea/vomiting; nor those caused by antidepressant medications, such as gastrointestinal upset, dry mouth, sexual dysfunction, weight gain, or sedation.
The most serious risk of rTMS is seizures. However, the risk of a seizure is exceedingly low (about 1 in 30,000 treatments). At NonSurgical Medical Group, we follow up-to-date safety guidelines that are designed to minimize the risk of seizures. While Neuromodulation (rTMS) is a safe procedure, it is important to point out that because it is a new treatment, there may be unforeseeable risks that are not currently recognized.
Who cannot get Neuromodulation (rTMS) therapy?
Patients with any type of non-removable metal in their heads (with the exception of braces or dental fillings) should NOT receive Neuromodulation (rTMS). Failure to follow this rule could cause the object to heat up, move, or malfunction, and result in serious injury or death. The following is a list of metal implants that can prevent a patient from receiving rTMS:
- Aneurysm clips or coils
- Stents in the neck or brain
- Deep brain stimulators
- Electrodes to monitor brain activity
- Metallic implants in your ears and eyes
- Shrapnel or bullet fragments in or near the head
- Facial tattoos with metallic or magnetic-sensitive ink
- Other metal devices or object implanted in or near the head
Who will benefit the most from Neuromodulation (rTMS) therapy?
Existing evidence to date suggests that patients who are less treatment-resistant respond better to Neuromodulation (rTMS) than those who are highly treatment-resistant. However, there is much yet to be learned about particular variables that may impact response to Neuromodulation. Researchers are presently conducting clinical studies to evaluate who will benefit most from Neuromodulation (rTMS) therapy. For example, there is much interest in evaluating whether Neuromodulation with pain medications or antidepressant medications is more effective than Neuromodulation alone.
If you have been diagnosed with Neuropathic pain, Fibromyalgia, Complex Regional Pain Syndrome (CRPS Type I), Trigeminal Neuralgia, or other central sensitization chronic pain conditions and continue to suffer chronic pain after standard treatment, you may qualify for our non-invasive, non-pharmaceutical Neuromodulation (rTMS) therapy.
How can I get Neuromodulation (rTMS) treatment?
Neuromodulation (rTMS) is the exclusive brain stimulation therapy offered at NonSurgical Medical Group for the treatment of chronic pain conditions.
Before scheduling you for treatment, you must first consult with our Executive TMS Technician (Phase 1 Consultation) and if qualified, you would then be scheduled to consult with our TMS physician (Phase 2 Consultation) to determine if Neuromodulation (rTMS) would be safe and appropriate for you.
To be considered for Neuromodulation (rTMS) treatment, patients must have been diagnosed with specific chronic pain conditions and unsuccessfully treated using accepted clinical guidelines… that is, Neuromodulation (rTMS) is for patients who have experienced inadequate response to pain medications or are pain medication intolerant.
Is Neuromodulation (rTMS) treatment covered by my insurance?
No. Neuromodulation (rTMS) treatment for chronic pain conditions is presently not covered by Medicare or general health insurance.
How much does Neuromodulation (rTMS) therapy cost?
Across the country, the average cost of the Neuromodulation (rTMS) procedure is about $400 per session. At NonSurgical Medical Group, we provide this advanced treatment technology at $300 per session… that is, 25% below the current industry average fee. We offer additional discount options and interest free payment plans for your convenience.