A new neurostimulation device is helping people find relief from chronic lower back pain by rebuilding weak multifidus muscles, which help stabilize the lower spine. Called multifidus stimulation, the treatment has been shown to reduce pain in three to six months after the device is surgically implanted. Here, Duke spine surgeon Peter Passias, MD, explains how multifidus stimulation works and whether you could be eligible.
Learn how multifidus stimulation works.
What Is Neurostimulation, and How Does It Treat Back Pain?
Neurostimulation uses small, surgically implanted devices to send electrical pulses to carefully targeted nerves. The technology has been used for years to treat pain by blocking pain signals or retraining pain receptors.
How Does Multifidus Stimulation Work?
Multifidus stimulation works differently than traditional neurostimulation. “This is more of a muscle-building approach,” said Dr. Passias. “We’re stimulating the nerves in the middle of the lower back that innervate, or activate, the multifidus muscles, which run along both sides of the spine.” These muscles weaken over time and lose their ability to support the spine, which can contribute to pain.
Because multifidus muscles are involuntary, meaning they function without conscious effort, they’re difficult to strengthen with traditional exercise. Multifidus stimulation causes the muscles to contract and relax many times over a period of about 30 minutes. Just like any other muscles that are exercised regularly, the multifidus muscles grow, become stronger, and do a better job supporting the spine.
Users can adjust the level of stimulation, schedule what time of day or night they want the stimulator to work, and choose how many sessions they want each day. According to Dr. Passias, many users say they can’t feel the stimulation happening.
What Is the Surgical Procedure Like?
The minimally invasive procedure takes place in an operating room and requires general anesthesia. Surgeons make two small incisions, one in the middle of the lower back where two thin wires called leads (which will transmit electricity) are attached to the multifidus muscles. Another incision is made in the side of the abdomen or near the back beltline, where the battery-operated power source is placed and connected to the leads.
Most people go home the same day. After a few weeks, your doctor will activate your multifidus stimulator and work with you to adjust its initial schedule and settings.
Is Multifidus Stimulation Right for Me?
According to Dr. Passias, you may be eligible for multifidus stimulation if:
- An MRI shows you have multifidus muscle atrophy.
- There is no clear neurological or orthopaedic cause for your low back pain.
- You have not found adequate relief from conservative treatments, like physical therapy or medication.
“These are cases where there's no high-grade spinal stenosis, there are no major deformities of the spine, there is no instability of the spine, but these patients still have debilitating symptoms of back pain,” Dr. Passias said.
Considering Multifidus Stimulation? Choose Duke
Duke is one of only a handful of centers in the Southeast offering multifidus stimulation as a treatment option for low back pain. Duke surgeons have the experience to identify who will benefit the most from multifidus stimulation, perform the procedure with excellent outcomes, and help you find relief from your pain.
