Restorative Neuromodulation for Patients With Chronic Low Back Pain

presented by Christopher Gilligan, MD and Kyle Kiesel, PT, PhD

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Disclosure Statement:

Financial:

Mainstay Medical buys out time from Dr. Gilligan’s contract to allow him to do research.

Kyle Kiesel is the owner of Functional Movement Systems. He is also a consultant at Mainstay Medical.

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Chris Gilligan has no competing nonfinancial interests or relationships with regard to the content presented in this course.

Kyle Kiesel has no competing nonfinancial interests or relationships with regard to the content presented in this course.

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Video Runtime: 43 Minutes, Learning Assessments: 28 Minutes

Low back pain (LBP) continues to be the primary source of years lived with disability worldwide and a challenge and source of frustration for clinicians who treat patients with chronic low back pain (CLBP). Rehabilitation providers have seen a variety of updated models and treatment techniques over recent years, such as pain neuroscience education. There have been updated approaches from the medical perspective as well. This course reviews recent updates in the treatment of CLBP from the medical field, including a novel application of restorative neuromodulation targeting low back muscle dysfunction.

Meet Your Instructors

Christopher Gilligan, MD

Dr. Gilligan's original training is in Emergency Medicine, with subspecialty training in Pain Medicine, where he has focused on pain of spinal origin. Dr. Gilligan's clinical expertise is focused on the treatment of pain related to disorders of the spine. He also treats patients with a wide range of pain conditions, including cancer-related pain, complex…

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Kyle Kiesel, PT, PhD

Dr. Kiesel is a professor of physical therapy at the University of Evansville and a cofounder of the Functional Movement System. During his 20 years in academics, he has spent nine years directing programs in athletic training and physical therapy. His areas of research include motor control of the core, breathing, and functional movement testing…

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1. Advances in CLBP Treatment: An Introduction to Neuromodulation

In this chapter, we cover the evidence demonstrating the continued debilitating effect of CLBP worldwide. Current medical treatments are discussed and a novel restorative neuromodulation technique is introduced.

2. Update on Multifidus Dysfunction and CLBP

Emerging evidence has demonstrated that lumbar multifidus dysfunction contributes to CLBP in a large portion of patients. In this chapter, we discuss current thoughts on why the multifidus becomes a primary contributor to reduced motor control and associated CLBP.

3. Novel Restorative Neurostimulation: Results From a Randomized Controlled Trial

Utilizing electric stimulation to restore muscle function is a commonly used technique in rehabilitation. In this chapter, we cover the results of a multisite randomized controlled trial demonstrating the long-term effect that applying restorative neurostimulation to the multifidus muscle has on associated pain and self-reported disability in a large sample of patients with CLBP.

4. Patient Selection and Clinical Testing

Patient selection is the silent secret of success for many medical treatment decisions. In the chapter, we cover the key aspects of selecting patients who would likely respond to restorative neurostimulation as a treatment for CLBP, including the description and demonstration of the two best clinical tests to identify multifidus dysfunction in this population.

5. Patient Interview and Closing

Research and evidence related to a novel medical treatment are great and required to demonstrate safety and efficacy, but individual results from the treatment are just as important. In this chapter, we interview a patient who has had the novel restorative neurostimulation implant as she tells her story of the ups/downs and frustration caused by years of CLBP and the joy she now feels because her pain is gone.