Clinical and Quality of Life Benefits for End-Stage Workers’ Compensation Chronic Pain Claimants following H-Wave® Device Stimulation: A Retrospective Observational Study with Mean 2-Year Follow-Up

Trinh, Alan; Williamson, Tyler; Han, David K.; Hazlewood, Jeffrey E.; Norwood, Stephen M.; Gupta, Ashim

doi:10.3390/jcm12031148

Cited by 6 publications

(33 citation statements)

References 24 publications

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“…A cohort survey study of first responders using HWDS made available at the job site demonstrated multiple work-related performance improvements [ 48 ]. A large observational cohort study of end-stage workers’ compensation chronic (mean 8 years) pain patients found that HWDS treatment led to significant QoL gains, in terms of improved function, reported pain, and decreased medication use [ 49 ].…”

Section: Resultsmentioning

confidence: 99%

Do Electrical Stimulation Devices Reduce Pain and Improve Function?—A Comparative Review

Allen,

Williamson,

Norwood

et al. 2023

Pain Ther

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Background Multiple forms of electrical stimulation (ES) potentially offer widely varying clinical benefits. Diminished function commonly associated with acute and chronic pain lessens productivity and increases medical costs. This review aims to compare the relative effects of various forms of ES on functional and pain outcomes. Methods A comprehensive literature search focused on studies of commonly marketed forms of ES used for treatment of pain and improvement of function. Peer-reviewed manuscripts were categorized as “Important” (systematic review or meta-analysis, randomized controlled trial, observational cohort study) and “Minor” (retrospective case series, case report, opinion review) for each identified form of ES. Results and Discussion Varying forms of ES have markedly different technical parameters, applications, and indications, based on clinically meaningful impact on pain perception, function improvement, and medication reduction. Despite being around for decades, there is limited quality evidence for most forms of ES, although there are several notable exceptions for treatment of specific indications. Neuromuscular electrical stimulation (NMES) has well-demonstrated beneficial effects for rehabilitation of selective spinal cord injured (SCI), post-stroke, and debilitated inpatients. Functional electrical stimulation (FES) has similarly shown effectiveness in rehabilitation of some stroke, SCI, and foot drop outpatients. H-Wave ® device stimulation (HWDS) has moderate supportive evidence for treatment of acute and refractory chronic pain, consistently demonstrating improvements in function and pain measures across diverse populations. Interestingly, transcutaneous electrical nerve stimulation (TENS), the most widely used form of ES, demonstrated insignificant or very low levels of pain and functional improvement. Conclusion Ten of 13 reviewed forms of ES have only limited quality evidence for clinically significant reduction of pain or improvement of function across different patient populations. NMES and FES have reasonably demonstrated effectiveness, albeit for specific clinical rehabilitation indications. HWDS was associated with the most clinically significant outcomes, in terms of functional improvement combined with reduction of pain and medication use. More rigorous long-term clinical trials are needed to further validate appropriate use and specific indications for most forms of ES. Level of Evidence II.

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Section: Resultsmentioning

confidence: 99%

Do Electrical Stimulation Devices Reduce Pain and Improve Function?—A Comparative Review

Allen,

Williamson,

Norwood

et al. 2023

Pain Ther

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“…[ 51 ], this small study provides additional anti-pain positive clinical metrics. In future studies, we can compare larger case groups to gain additional insights into the value of this approach to protocol building to address the complexity of severe chronic pain, whether lengthy [ 52 ] relatively short in duration.…”

Section: Discussionmentioning

confidence: 99%

Positive Clinical Outcomes for Severe Reported Pain Using Robust Non-Addictive Home Electrotherapy—A Case-Series

Bajaj

Han

Elman

et al. 2023

JPM

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The North American opioid epidemic has resulted in over 800,000 related premature overdose fatalities since 2000, with the United States leading the world in highest opioid deaths per capita. Despite increased federal funding in recent years, intended to address this crisis, opioid overdose mortality has continued to increase. Legally prescribed opioids also chronically induce a problematic reduction in affect. While an ideal analgesic has yet to be developed, some effective multimodal non-opioid pharmacological regimens for acute pain management are being more widely utilized. Some investigators have suggested that a safer and more scientifically sound approach might be to induce “dopamine homeostasis” through non-pharmacological approaches, since opioid use even for acute pain of short duration is now being strongly questioned. There is also increasing evidence suggesting that some more robust forms of electrotherapy could be applied as an effective adjunct to avoid the problems associated with opioids. This 4-patient case-series presents such an approach to treatment of severe pain. All 4 of these chiropractic treatment cases involved a component of knee osteoarthritis, in addition to other reported areas of pain. Each patient engaged in a home recovery strategy using H-Wave® device stimulation (HWDS) to address residual extremity issues following treatment of spinal subluxation and other standard treatments. A simple statistical analysis was conducted to determine the change in pain scores (Visual Analogue Scale) of pre and post electrotherapy treatments, resulting in significant reductions in self-reported pain (p-value = 0.0002). Three of the four patients continued using the home therapy device long-term as determined by a post-analysis questionnaire. This small case-series demonstrated notably positive outcomes, suggesting consideration of home use of HWDS for safe, non-pharmacological and non-addictive treatment of severe pain.

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“…Norwood et al reported patient-recorded outcome measures (PROMs) for 2,711 non-specific chronic low back pain, sprain, strain HWDS patients, resulting in substantial pain improvement (3.12 on a 0–10 visual analogue scale), with profound positive effects on function and ADL, in addition to benefits like decreased medication use, better sleep, and improved work performance ( 14 ). Trinh et al in a large retrospective cohort study involving end-stage worker's compensation patients, reported no adverse effects associated with HWDS, with significant reduction in pain, opioids/polypharmacy use, and anxiety/depression, while improving overall QoL ( 2 ). Williamson et al in a retrospective cohort study involving first responder firefighters, reported easy device use and no untoward side-effects with HWDS, with statistically significant reduction in reported pain, improvements in ROM and job performance, and increased time spent with family, leading to overall positive health benefits and experience ( 1 ).…”

Section: Mechanism Of Action and Effectiveness On Pain And Functionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Chronic musculoskeletal pain, stemming from soft tissue inflammation and injury, has been estimated to occur in up to half of adults worldwide, accounting for hundreds of billions of dollars in healthcare costs ( 1 , 2 ). Functional deficits including decreased range of motion (ROM) and interference with activities of daily living (ADL) are frequently associated with persistent pain ( 1 , 2 ). With an increasing prevalence of chronic pain and its associated effects on quality of life (QoL), traditional forms of treatment have included prescription of pharmacological agents including non-steroidal anti-inflammatory drugs and opioids; non-pharmacological approaches like activity modification, physical therapy, cognitive behavioral therapy, complementary and alternative medicine (e.g., acupuncture); as well as various invasive interventions (e.g., radiofrequency ablation) ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

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Transcutaneous electrical nerve stimulation vs. H-Wave® device stimulation—similar or different?

Gupta,

Norwood

2024

Front. Pain Res.

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Clinical and Quality of Life Benefits for End-Stage Workers’ Compensation Chronic Pain Claimants following H-Wave® Device Stimulation: A Retrospective Observational Study with Mean 2-Year Follow-Up

Cited by 6 publications

References 24 publications

Do Electrical Stimulation Devices Reduce Pain and Improve Function?—A Comparative Review

Do Electrical Stimulation Devices Reduce Pain and Improve Function?—A Comparative Review

Positive Clinical Outcomes for Severe Reported Pain Using Robust Non-Addictive Home Electrotherapy—A Case-Series

Transcutaneous electrical nerve stimulation vs. H-Wave® device stimulation—similar or different?

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