How PNT helps with lower back pain (Research article)
PNT for lower back pain relief
The treatment involves the delivery of electrical stimulation
directly to the deeper tissues (muscles, ligaments,
tendons) near the spine through several needle electrodes.
Careful placement of the needle electrodes is designed
to reach the nerve pathways that may be impacting the
pain. The theory is that this type of electrical stimulation
helps curtail the central nervous system hypersensitivity
that leads to persistent pain.
In addition to improved lower back pain relief, early studies
have indicated that many patients receiving percutaneous
electrical stimulation (such as PNT) reported the following
improvements:
-
Increased physical activity
-
Reduced need for pain medications
-
Improved quality of sleep.4,5,6
Treatment approach to reduce lower back pain
PNT is designed for treating patients with lower back
pain in the physician’s office. A typical PNT therapy
session is as follows:
The patient lies face down on an examination table.
-
Once the patient is comfortable, up to 10 PNT
electrodes (called "Safeguides”) are
applied to the lower back and buttock area at specific
locations.
-
Each Safeguide deploys a fine-gauge filament electrode
- approximately two-to-three times the size of a human
hair - to a depth of three centimeters. For most patients,
this insertion causes little or no discomfort
-
After deploying the electrodes, the physician adjusts
the electrical stimulation to a level that will deliver
therapeutic benefit with minimal discomfort.
The stimulation typically results in a deep tingling
or tapping sensation in the area surrounding the electrodes.
During the 30-minute session, patients are asked to
relax and remain still. After the treatment is done,
the electrodes are removed and patients may go home
or back to work - there are no activity restrictions
for patients after the procedure.
Patients are generally advised to commit to a course
of three to four PNT sessions before evaluating the
procedure’s effectiveness, as multiple sessions
are typically required before a measurable benefit may
be experienced.
Some patients may experience some level of pain relief
after just a single PNT session, and some may experience
little or no pain relief even after several sessions.
The most appropriate frequency of treatments and course
of therapy tend to vary for each patient.
Patients with complex spinal pathologies often are
best served through an integrated pain management approach.
Consequently, patients may undergo a course of PNT alone,
or in combination with other therapies as part of a
multidisciplinary low back pain treatment plan.
PNT clinical trial results
In a recent non-controlled, non-blinded multi-center
study, researchers examined the effect and benefit of
PNT on a population of low back pain patients with pain
radiating into the lower extremities (legs and feet).
Patients receiving PNT therapy reported the following
overall benefits:
-
Improved pain control
-
Increase activity levels
-
Reduces use of pain medications
-
Enhanced quality of sleep
-
Lower levels of disability.6
Approximately three quarters of patients completing
the study said that they would want to receive PNT treatments
again if they were to experience another episode of
low back pain.6 There was no control group
for comparison in this study.
No significant complications or side effects were reported
during the study.
As with all new treatments, there are no long-term
studies available on the effectiveness, potential risks
or complications of PNT. To date, no independent, randomized
clinical trials have been performed.
Conclusion on PNT for lower back pain relief
PNT is a new, minimally invasive procedure that has
recently been cleared by the FDA. This treatment has
been developed for patients who have not achieved enough
pain relief through conservative treatments (such as
physical therapy, medications, chiropractic or osteopathic
treatments) and are considering more invasive and expensive
procedures. Early studies indicate that PNT appears
to reduce pain and improve activity levels for a wide
range of patients with low back pain.
By:
John P. Revord, MD
August 26, 2002
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