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SMALL WONDER: The Protégé.
SMALL WONDER: The Protégé.

Relief by the volt

Technology | Implantable medical devices for chronic pain are shrinking in size and growing in popularity

Issue: "Fighting fatalism," July 12, 2014

Treating pain with wires and battery-powered gadgets instead of pills might sound a little too much like Star Trek. But that’s just what many pain-sufferers are doing.

In March the U.S. Food and Drug Administration gave pre-market approval to the Protégé implantable neurostimulator, a pacemaker look-alike made by St. Jude Medical for treating chronic pain in the back or limbs. Such devices have existed for several years, but Protégé is the smallest of its kind (it weighs just 1 ounce), and is the first with upgradeable software.

The market for neurostimulator implants—otherworldly as they seem—was worth an estimated $2.6 billion in 2012 and continues to grow rapidly. Manufacturers are selling neurostimulators to treat a variety of pains and diseases, such as phantom pain or Parkinson’s disease. One device approved by the FDA in April treats sleep apnea by stimulating a nerve that keeps the upper airway open. Another has been used to treat migraine headaches, although that use is not yet FDA endorsed.

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Neurostimulators are often used to treat back pain, such as from a failed back surgery. They work this way: A doctor implants electrodes near the patient’s spinal cord. Those electrodes attach to wires running beneath the skin, which connect to a battery-powered stimulator implanted in the abdomen or buttocks. The stimulator sends out faint electrical impulses that cancel out pain signals traveling from the back or limbs toward the brain. A remote control allows the patient to adjust the stimulation strength up or down.

Neurostimulation blocks pain, but doesn’t cure the source. It sometimes only decreases pain instead of eliminating it, and it doesn’t work for every patient: Some say their pain persisted or grew worse after getting an implant.

Harriet Borgman, however, says her neurostimulator was a huge success. Her pain following a prior neck surgery was so intense she had trouble driving, and a doctor said the pain medication he could prescribe might interfere with her thinking. She agreed to try an implant. Since the surgery last September, she told me, her pain is at least 90 percent gone: “I never would have guessed it would be this good again.” She recharges the device’s battery wirelessly with a special belt she straps to her waist.

Perhaps more surprising is that Borgman, a retired teacher from a Christian school, is 81 years old. She still cuts her grass in McBain, Mich., using a push mower, and volunteers at a thrift shop.

Somehow, knowing Borgman uses an implant makes neurostimulation seem as down-to-earth as homemade apple pie.

States of surveillance

Justin Tallis/AFP/Getty Images

Global telecommunications giant Vodafone revealed in June that about six nations have legal, direct access to its phone lines, allowing governments to eavesdrop or record conversations without warning. In a global transparency report on government surveillance, Vodafone said many of the 29 countries where it operates in Europe, Africa, the Middle East, and elsewhere routinely request phone call metadata or tap lines. Among nations that permitted figures to be published, Italy beat out Tanzania and Hungary as the top metadata spy, requesting information like names, phone numbers, and location data 605,601 times over 12 months. Verizon and AT&T have previously reported the United States also makes hundreds of thousands of such requests. —D.J.D.

Daniel James Devine
Daniel James Devine

Daniel is managing editor of WORLD Magazine and lives in Indiana. Follow Daniel on Twitter @DanJamDevine.


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