Tackling the chronic pain crisis in a post-COVID world

BioWaveGO medical consultant and pain management expert Dr Dominic Hegarty talks about the critical role neuromodulation devices can play in the treatment of chronic pain. 

Managing the immediate demands and costs of the Coronavirus pandemic (COVID-19) has tested the world’s healthcare systems to their limits. As we move forward, the new challenges presented by this impact must be faced. 

Now more than ever there is a need for European healthcare systems to be bold and embrace new, diverse treatment options to not only reduce huge waiting lists but also minimise healthcare expenditure in an effort to diminish public sector deficits. With chronic pain sufferers often seeking medical attention, a recent report estimated the total cost for healthcare systems across Europe could be as high as €300 billion. These statistics are not surprising given that one in five European’s suffer from chronic pain. 90% of these costs can be attributed to indirect costs such as lost productivity, social security and welfare payments. Conditions such as lower back pain and osteoarthritis, are prominent causes of disability worldwide according to the Global Burden of Disease reviews. In the UK alone the burden of chronic pain continues to increase and between eight and sixteen million people in the UK live with moderate-to-severe pain.

Factors influencing prevalence:

Underestimation

In 2016 the British Medical Journal pooled prevalence estimates for chronic pain and chronic widespread pain and estimated it could be three times higher than anticipated (43%) in the UK. This equates to just under 28 million people suffering from chronic pain. One in five Europeans are recognised to suffer with chronic pain on a daily basis but it’s extremely likely this figure could be higher.

Age stratification

Chronic pain prevalence rises steadily with increasing age, affecting up to 62% of the population over the age of 75. With an ageing population we can expect this association to increase the demands on the healthcare sector in line with their needs.

When chronic pain prevalence is stratified by age group a worrying trend emerges. The prevalence in younger individuals (18-29 years) may be as high as 30%. Traditionally younger individuals would not have been expected to be the key end users of pain services. The need to recognise individuals sooner and to provide long-term drug free solutions is vital. 

Severity of pain

Naturally pain is very personal and severity can vary. The weighted average for chronic widespread pain suggest that between 10.4% and 14.3% of the population report chronic pain that is either “moderately or severely limiting.” This figure is flawed because it does not take into account those individuals who regard their pain as “mild-to-moderate.” These are individuals for whom pain impacts their daily function, reduces their quality of life but they manage to get by. This cohort are statistically speaking ignored because they are not deemed serious enough.

Is chronic pain preventable?

Without exception any individual who suffers acute pain has the potential to develop chronic pain. This transition can be seen within three months so early recognition and intervention is important. Although genetic and social factors may predispose an individual to chronic pain, risk factors such as repetitive strain, depression, poor sleep, stress, maladaptive postures, and ergonomic factors are among major factors leading to delayed recovery, failed treatment, and continued pain.

Two simple models that can be used to focus on prevention and providing early drug free interventions:

• A human systems approach where we provide an emphasis on understanding the role that lifestyle risk factors play in perpetuating chronic pain through recursive feedback cycles that increase peripheral and central sensitisation. Increased awareness can improve outcome.
• A transformative care model is the clinical application of a human systems approach, integrating patient self-assessment and self-management training with evidence-based treatments. If we are to empower individuals to self-manage pain then it is critical that technology, and bioelectric medicine in particular, is used to help patients to reduce risk factors, enhance protective factors, and halt the cycle of chronic pain.

Bioelectric medicine offers drug free solutions.

Traditionally spinal cord stimulation and the use of low voltage energy to inhibit the pain pathway, has been seen as the last resort in pain management. While the barriers to treatment are falling this extremely useful therapy is costly and the expertise required to implant the equipment has limited the accessibility globally. 

But things are changing. The FDA approval for new neuromodulation devices grew by 32% in the last decade and growth in this area is anticipated to be the leading opportunity for growth in the medtech sector between 2016-2026. 

This growth in new non-invasive bioelectronic medicine (i.e. wearable devices) will provide the solution needed by so many. BioWaveGO - a new non-invasive neuromodulation device that has just received a CE mark for distribution across the UK and Europe has the potential to revolutionise the way pain is treated. Unlike TENS, which delivers a signal across the surface of the skin, BioWave’s smarter pain blocking technology delivers a signal straight to the nerve to target pain directly at the nerve base with electrical waves. Using the multiplication of two sine waves (i.e. a Fourier Transform) to bypass the skin and modulate the nerve fibres directly, the electrical field generated by BioWaveGO technology leads to hyperpolarised C-fibres, in turn inhibiting action potentials from propagating along the pain fibres to reduce pain sensations. Utilising electrical waves rather than chemicals, the device blocks pain at its source, providing relief from the sudden onset of severe pain and offers acute relief for up to 24 hours following a 30-minute treatment.

The FDA and CE certified medical grade device has a proven track record, with the ground-breaking American technology being used across medical and professional sports settings to treat pain for the past 13 years. Our recently published research assessed the benefit of the BioWave device on several pain conditions and there is clear evidence that this simple, cost-effective device can offer a viable clinical solution. The device has been particularly effective for individuals suffering mild to moderate symptoms, with 80% of patients finding a BioWaveGO treatment has reduced the pain they are experiencing by around 60%. 

Conclusion 

The use of non-invasive bioelectronic technology to provide drug free pain solutions offers a huge opportunity to intervene in the fight against chronic pain. It finally offers us the opportunity to personalise pain management. With an ageing population and with a greater number of younger individuals reporting pain, clinician’s and the medtech industry must work together to harness the power of technology to treat the biggest chronic medical condition we face in society today.