Pain Relief > Pain Management
Pain is a global issue, thereby making pain management and pain relief of paramount importance. Whether it be from immediate acute pain or from chronic pain, which develops and lasts over time, pain causes many to suffer. Pain may stem from some form of bodily or soft tissue injury like a torn ACL, a very common knee injury; however, many experience ongoing chronic pain (like low back pain or knee pain) due to an unknown etiology, or cause, until assessed by a physician. While many seek pain relief from physicians and other medical professionals, pain management is all that is provided through prescription drugs and injections. As a global society, people are in search for more than just pain management, they are on a conquest for a natural pain relief source.
Acute pain, though it generally disappears, may eventually translate into chronic pain, and it is chronic pain that is the main culprit of pain and disability in society [1,2]. One in five adults suffer from chronic pain which has been defined as having pain almost every single day for approximately 6-months . Other estimates of chronic pain among adults have ranged anywhere from 11% to 40% depending on the population [4,5,6]. Chronic pain has become a public health concern and is one of the most common reasons adults actually seek medical care with approximately 22% of doctor appointments being scheduled to address chronic pain . All this to say, pain is placing restrictions on mobility/activity, causing a loss of independence, and essentially stealing the lives from us and others in our community.
This may be due to the healthcare system focusing primarily on pain management as opposed to actual pain relief. Though pain management may be a step towards pain relief, dependence on opioids has increased , pain related anxiety and depression are on the rise , and people are experiencing poorer perceived health and reduced quality of life due to pain [1,2]. Pain is continuing to skyrocket and the societies on every continent are in search for an answer. As opposed to using natural analgesic (pain relieving) solutions, patients are being recommended more injections and medications.
The American Academy of Pain Medicine provides clear guidelines for a chronic pain diagnosis treatment. Key components that constitute an effective treatment include a combination of medication therapy consisting of analgesics (pain relievers like: nonsteroidal antiinflammatory drugs [NSAIDs] and opioids) as well as antidepressants and anticonvulsants . The recommendation and answer to suffering from chronic pain appears to be medications piled on top of medications. After studying approximately 690 million outpatient visits made for chronic pain, researchers discovered that of those patients, 99% received a medication that could be used for chronic pain . Among those patients, 29% reported taking five or more medications . It is no wonder why the total costs of prescription medications prescribed for pain was approximately $17.8 billion annually and that the use of opioids for pain has resulted in approximately 2.4 million people (just in America) suffering from opioid use disorder [7,9]. It is imperative that the global population have access to an FDA approved technology for the achievement of full pain relief and to be rid of restrictions on life due to pain.
Back in 2015, PowerDot became the first ever FDA approved app-based Neuromuscular Electrical Stimulation (NMES) technology bringing federally approved and affordable pain relief to the masses. PowerDot is also an FDA approved Transcutaneous Electrical Stimulation (TENS) unit. What this means is that PowerDot harnesses the technology of both NMES and TENS, at the highest regulated level of approval, to provide pain relief. Through the PowerDot app, everyone has access to both NMES and TENS pain relieving technology all powered via bluetooth, preventing the mess and disorganization of multiple clunky machines and tangled wires. PowerDot streamlines pain relief and provides the opportunity for everyone to experience natural pain relief helping people move well, move often, and move pain free.
Common Chronic Pain
There are multiple mechanisms at the root of chronic pain (physical, (bio)mechanical, and/or physiological). For instance, chronic pain may be due to a physical soft tissue injury , mechanopathology (an injury as a result of poor movement mechanics) , and/or physiological alterations such as dysregulation of cytokines (proteins that mediate inflammation and immunity), adipokines (cytokines secreted from fat tissue), and hormones that negatively impact joint health causing pain .
The human body senses, or perceives pain, via free nerve endings located in the skin, muscles, joints, bones, and viscera (organs in the body) that respond to noxious (unpleasant) stimuli. The receptors that sense unpleasant, painful, stimuli are called nociceptors. Nociceptors are stimulated by proinflammatory molecules resulting in peripheral hyperglasia (enhanced pain response). Meaning, nociceptors are stimulated to send a signal to higher brain centers to be processed and determine whether pain should be sensed. Thus, there is a modulation system so that not every signal elicits a pain response. Though, in someone suffering from chronic pain, nociceptors are highly excitatory resulting in continual pain perception. The two most common forms of chronic pain stem from osteoarthritis and chronic low back pain.
The Wear and Tear Disease: Osteoarthritis
As previously mentioned, pain may stem from physical, (bio)mechanical, and/or physiological alterations and osteoarthritis (OA) is no exception and may involve all three mechanisms. OA is commonly referred to and known as the “wear and tear” disease and is prevalent in joints that have to deal with a lot of stress (knees, hips, and low back) . As more research is conducted on OA, beyond the physical wear and tear mechanism, further evidence also suggests a strong role of systemic physiological factors (such as genetics, diet, hormones, and bone density) as well as local (bio)mechanical factors (such as muscle weakness, obesity, and joint laxity) .
Arthritis is the most common joint disorder in the United States impacting over 23% of the population and the lifetime risk of developing OA is 45% [14,15]. And this number is not expected to decline. It is estimated that in the next 20 years approximately 78 million adults will suffer from arthritis (and that’s just those that go to the doctor to be diagnosed). Pain from OA is a key symptom in the decision to seek medical care and is an important antecedent to disability, though by this point, it may be too late . Knee OA specifically is one of the few diseases (alongside stroke, heart disease, and a few others) that accounts for more physical disability in elderly populations than any other disease . Because of its high prevalence and the frequent disability that accompanies disease in major joints such as the knee and hip, OA accounts for more difficulty with climbing stairs and walking than any other disease . Meaning, human movement is compromised and independence is lost.
The constant stressors that lead to alterations (physical, (bio)mechanical, and/or physiological) result in the loss and damage of articular cartilage, alterations in bone formation and maladaptations, as well as inflammation of the synovial membrane and thickening of the joint capsule . Articular cartilage is the smooth tissue that covers the ends of bones where they come in contact with one another so there is no direct bone on bone contact. Eventually, all of these alterations result in narrowing of the joint space and consequently to bone on bone contact causing the common painful symptoms associated with OA like joint stiffness and swelling. Pain and stiffness may occur for approximately 30 minutes after waking up from a nap or after sitting for a while. The swelling may be caused by joint effusion (an excess amount of fluid in the joint) or from the enlargement and bulging of bone. At the end of the day, all of these factors combined, result in limited range of motion and chronic pain.
The Most Common Pain Location: Low Back Pain
Chronic low back pain (LBP) may also emanate from all three mechanisms of pain (physical, (bio)mechanical, and physiological). This pain may be due to physical stress from axial loading (ie. running), mechanically by improper body mechanics during everyday movements such as picking up boxes with poor posture, and/or physiologically due to hormone and inflammation alterations . It has been estimated that 75-85% of individuals will experience back pain at some point in their lives . It has previously been reported that there has been a 60.5% increase in primary lumbar spine fusion surgeries and it is estimated that 27% of hospital admissions for low back pain undergo surgical intervention [20,21].
Now, how can it be determined if the LBP is physical, mechanical, and/or physiological? Research findings suggest, constant pain and stiffness after resting are considered to be indicators of inflammatory LBP while intermittent pain during the day, or pain that gradually worsens over the course of a day due to standing, lifting, driving… essentially doing things, are considered indicators of mechanical low back pain .
With the rise in LBP and OA, two major pathologies that cause chronic pain, as well as serious medical interventions to help manage that pain, it is time to seek a natural alternative to full pain relief.
The Future of Pain Relief is Here
PowerDot NMES and TENS technology has been specifically designed to not just provide a mechanism of pain management, but rather pain relief, thus decreasing the dependency upon medications or surgery to help. Specifically, TENS has been studied as a nonpharmacological and non-invasive intervention to reduce opioid utilization. TENS releases endorphins and/or blocks pain signals sent to the central nervous system reducing the pain sensation. TENS has also been found to naturally interact with opioid receptors to produce pain relieving effects . With limited or no pain as a result of TENS therapy, patients will not need or require opioids, lowering the costs to patients for the treatment of pain [24,25].
Those with arthritis tend to decrease physical activity as it becomes too painful to want to even get up… let alone go exercise. The combination of TENS and NMES may not only help to get people moving pain free but also improve physical function in the long run. The use of TENS in people with arthritis provides a therapeutic treatment that results in analgesia, or the inability to feel pain. TENS therapy blocks the pain signals sent to the brain . Researchers have previously concluded that adding TENS to exercise training tended to produce the best overall improvement in physical outcomes in people with OA . As arthritis limits physical activity and function, muscles atrophy (get smaller and weaker) which leads to even greater physical impairments. This is where NMES comes in. NMES training in those with arthritis not only improved muscular strength and increased the size of the muscle, but reduced pain, stiffness, and functional limitations in patients with arthritis .
Now, those with chronic LBP demonstrate a less efficient muscle control control system and inability to provide necessary spinal stability for everyday movements. Meaning their muscles have also atrophied and become weaker. Having a deconditioned lumbar extensor musculature is suggested to be a risk factor for low back injury and pain [28,29,30]. In order to enhance stability and muscular control efficiency in those with chronic LBP, strengthening of pelvic floor muscles, lumbar low back muscles, and the glutes is essential [28,31,32,33]. Adding PowerDot Smart TENS and NMES technology to therapy and strengthening may further reduce pain by up to 20% by optimized improvements in muscle strength, balance, and lumbar and pelvic stability [33,34].
At PowerDot, we aim to improve all aspects of human performance and optimal human performance begins with pain relief. Everyone should feel and perform their best, day in and day out, this means moving pain free. PowerDot technology has the potential to provide enhanced pain relief without medications or surgeries. Though, beyond just the reduction in pain, therapy utilizing PowerDot technology has the capacity to also improve activity levels, function, and quality of life. It is time to start living pain free with PowerDot.
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