Regional therapies for treatment of pain

• US 20070021801A1
• Filed: 03/14/2006
• Published: 01/25/2007
• Est. Priority Date: 06/09/2005
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Singhal, Ruchika, King, Gary, Schendel, Michael, Heruth, Kenneth, Lent, Mark
• Granted Patent: US 7,813,803 B2
• Time in Patent Office: Days
• US Class Current: 607/46
• CPC Class Codes: A61M 2205/054 with electrotherapy
• CPC Class Codes: A61M 2205/3523 using telemetric means
• CPC Class Codes: A61M 5/14276 specially adapted for implantation
• CPC Class Codes: A61M 5/172 electrical or electronic A61M5/16804, A61M5/16831 take precedence
• CPC Class Codes: A61M 5/1723 using feedback of body parameters, e.g. blood-sugar, pressure measurement of body parameters A61B5/00
• CPC Class Codes: A61N 1/025 Digital circuitry features of electrotherapy devices, e.g. memory, clocks, processors
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/372 Arrangements in connection with the implantation of stimulators
• CPC Class Codes: A61N 1/37229 Shape or location of the implanted or external antenna

Abstract

Enhanced therapies for treating pain are described. The therapies include subcutaneous stimulation of tissue in proximity to a source of pain at low frequencies (less than about 20 Hz) and high frequencies (greater than about 50 Hz). The subcutaneous stimulation may be applied in proximity to a structure in the back, such as discs, facet joints, nerve roots or ganglions, sympathetic chain, ligaments, muscles, and the like. Subcutaneous stimulation at high and low frequencies applied in combination with epidural stimulation is also described.

Claims

1. A method for treating pain in a subject in need thereof, the method comprising:

implanting a pulse generator in the subject;

generating via the pulse generator a first electrical signal having a frequency of less than about 20 Hz and applying the first electrical signal to a first subcutaneous region in proximity to a source of pain of the subject; and

generating via the pulse generator a second electrical signal having a frequency of greater than about 50 Hz and applying the second electrical signal to a second subcutaneous region in proximity to the source of pain of the subject,

wherein the first and second subcutaneous regions are the same or different.

2. The method of claim 1, wherein applying the first electrical signal to the first subcutaneous region in proximity to the source of pain comprises applying the signal in proximity to a structure of the back of the patient.

3. The method of claim 2, wherein applying the signal in proximity to a structure of the back of the patient comprises applying the signal in proximity to a disc or facet joint.

4. The method of claim 1, wherein applying the second electrical signal to the second subcutaneous region in proximity to the source of pain comprises applying the signal in proximity to a structure of the back of the patient.

5. The method of claim 4, wherein applying the signal in proximity to a structure of the back of the patient comprises applying the signal in proximity to a disc or facet joint.

6. The method of claim 1, wherein applying the first electrical signal to the first subcutaneous region in proximity to the source of pain comprises applying the signal in proximity to a muscle, nerve or ligament.

7. The method of claim 1, wherein applying the second electrical signal to the second subcutaneous region in proximity to the source of pain comprises applying the signal in proximity to a muscle, nerve or ligament.

8. The method of claim 1, wherein the applying the first and second electrical signals to the first and second subcutaneous regions comprises applying the first and second electrical signals to substantially the same or the same subcutaneous region.

9. The method of claim 1, wherein the applying the first electrical signal comprises applying the first signal through at least one first electrode of a set of one or more electrodes and wherein applying the second signal comprises applying the second signal through at least one second electrode of the set of one or more electrodes, wherein the at least one first electrode and the at least one second electrode are the same or different.

10. The method of claim 9 wherein the at least one first electrode and the at least one second electrode are the same one or more electrodes.

11. The method of claim 10, wherein applying the first electrical signal and applying the second electrical signal comprises periodically varying the frequency of the signal applied through the same one or more electrodes between the first and the second frequency.

12. The method of claim 1, wherein applying the first electrical signal and applying the second electrical signal comprises alternating between application of the first signal and application of the second signal.

13. The method of claim 12, wherein varying between application of the first signal and application of the second signal comprises application of the first signal for between about one second and about eight hours and application of the second signal for between about one second and about eight hours.

14. A method for treating pain in a subject in need thereof, the method comprising:

implanting a pulse generator in the subject;

implanting a set of one or more electrodes in the subject in proximity to a source of pain of the subject;

generating via the pulse generator a first electrical signal having a frequency of less than about 20 Hz and applying the first electrical signal to at least one of the set of one or more electrodes; and

generating via the implantable pulse generator a second electrical signal having a frequency of greater than about 50 Hz and applying the second electrical signal to at least one of the set of the one or more electrodes,

wherein the applying the first signal and applying the second signal comprises applying the first and second signal to the same or different one or more electrodes.

15. The method of claim 14, wherein implanting the set of one or more electrodes comprises subcutaneously implanting one or more leads comprising the set of electrodes.

16. The method of claim 14, wherein implanting the set of one or more electrodes in proximity to the source of pain of the subject comprises implanting at least one of the set of one or more electrodes in proximity to a nerve, muscle, or ligament.

17. The method of claim 14, wherein implanting the set of one or more electrodes in proximity to the source of pain of the subject comprises implanting at least one of the set of one or more electrodes in proximity to a structure of the subject'"'"'s back.

18. The method of claim 17, wherein implanting the at least one of the set of one or more electrodes in proximity to a structure of the subject'"'"'s back comprises implanting the at least one electrode in proximity to a disc or facet joint.

19. The method of claim 15, wherein subcutaneously implanting the one or more leads comprises implanting the one or more leads parallel to the spinal column.

20. The method of claim 19, wherein implanting the one or more leads comprises placing at least one of the one or more leads such that at least a plurality of electrodes extend over more than one vertebral level.

21. The method of claim 14, wherein implanting the set of electrodes comprises placing the plurality of electrodes subcutaneously along the subject'"'"'s spinal column such that the plurality of electrodes extend over more than one vertebral level.

22. A method for treating pain in a subject in need thereof, the method comprising:

implanting a pulse generator in the subject;

implanting a first set of one or more electrodes in the subject in proximity to a first source of pain;

implanting a second set of one or more electrodes in the subject in proximity to a second source of pain, which is the same as or different than the first source of pain;

generating via the pulse generator a first electrical signal having a frequency of less than about 20 Hz and applying the first electrical signal to at least one of the first set of one or more electrodes; and

generating via the pulse generator a second electrical signal having a frequency of greater than about 50 Hz and applying the second electrical signal to at least one of the second set of the one or more electrodes.

23. The method of claim 22, wherein implanting the first set of electrodes comprises implanting a first set of one or more leads comprising the first set of electrodes and wherein implanting the second set of electrodes comprises implanting a second set of one or more leads comprising the second set of electrodes.

24. The method of claim 22, wherein implanting the first set of one or more electrodes in the subject in proximity to the source of pain comprises implanting at least one of the one or more electrodes in proximity to a structure of the back of the subject and wherein implanting the second set of one or more electrodes in the subject in proximity to the source of pain comprises implanting at least one of the one or more electrodes in proximity to a structure of the back of the subject.

25. The method of claim 22, wherein implanting the first set of one or more electrodes and implanting the second set of one or more electrodes comprises implanting the first and second set of electrodes in proximity to the same source of pain.

26. A method for treating pain in a subject in need thereof, the method comprising:

implanting a first set of one or more electrodes in the subject in proximity to a source of pain;

epidurally implanting a second set of one or more electrodes in the subject;

applying a first electrical signal to at least one of the first set of one or more electrodes, the first electrical signal comprising a frequency of less than about 20 Hz; and

applying a second electrical signal to at least one of the second set of the one or more electrodes, the second electrical signal comprising a frequency of greater than about 50 Hz.

27. The method of claim 26, wherein implanting the first set of one or more electrodes in the subject in proximity to a source of pain comprises implanting at least one of the one or more electrodes in proximity to a structure of the back of the subject.

28. The method of claim 26, further comprising applying a third electrical signal to at least one of the first set of one or more electrodes, the third electrical signal comprising a frequency of greater than about 50 Hz.

29. The method of claim 28, wherein applying the first electrical signal and applying the third electrical signal comprises varying between applying the first signal and applying the third signal.

30. The method of claim 29, wherein varying between applying the first signal and applying the third signal comprises applying the first signal for between about one second and eight hours and applying the third signal between about one second and about eight hours.

31. The method of claim 29, wherein applying the first and third electrical signals comprises applying the signals to a disc or a facet joint.

32. The method of claim 26, wherein applying the first electrical signal to the first subcutaneous region comprises applying the signal to a disc or facet joint.

33. A computer readable medium programmed with instructions to cause an implantable pulse generator to alternate in a periodic manner between generating a first electrical signal having a frequency greater than about 50 Hz and generating a second electrical signal having a frequency less than about 20 Hz.

34. The computer readable media of claim 33, wherein the instructions cause the implantable pulse generator to generate a repeating pattern of the first signal for between about one second and eight hours and the second signal for between about one second and about eight hours.

35. The computer readable medium of claim 34, wherein the instructions cause the pulse generator to generate a repeating pattern of the first signal for between about two minutes and about two hours and the second signal for between about two minutes and about two hours.

36. An implantable pulse generator comprising the computer readable media of claim 33.

37. An implantable pulse generator comprising the computer readable media of claim 34.

38. A programming device capable of communicating instructions to an implantable pulse generator comprising the computer readable media of claim 33.

39. A programming device capable of communicating instructions to an implantable pulse generator comprising the computer readable media of claim 34.