Tibial nerve stimulation

• US 8,755,893 B2
• Filed: 06/20/2012
• Issued: 06/17/2014
• Est. Priority Date: 06/08/2010
• Status: Active Grant

• Current Assignee: BlueWind Medical Ltd.
• Original Assignee: BlueWind Medical Ltd.
• Inventors: Gross, Yossi, Kinrot, Noam, Oron, Gur, Ronen, Shlomo, Stern-Cohen, Ali, Neeman, Danny
• Primary Examiner(s): Alter, Alyssa M
• Application Number:
  US13/528,433
• Publication Number:
  US 20130066393A1
• Time in Patent Office: 727 Days
• Field of Search: 607/46, 607/48, 607/49
• US Class Current: 607/46
• CPC Class Codes: A61N 1/0556 Cuff electrodes
• CPC Class Codes: A61N 1/0558 Anchoring or fixation means therefor
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/3616 Voltage density or current density
• CPC Class Codes: A61N 1/36171 Frequency
• CPC Class Codes: A61N 1/372 Arrangements in connection with the implantation of stimulators
• CPC Class Codes: A61N 1/37205 Microstimulators, e.g. implantable through a cannula
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators

Abstract

A method is provided, including identifying a subject as suffering from pain in a first limb of the subject. In response to the identifying, treatment of the pain in the first limb is facilitated by implanting electrodes in a limb of the subject that is contralateral to the first limb. Other embodiments are also described.

Claims

1. A method, comprising:

identifying a subject as suffering from pain in a first limb of the subject; and

in response to the identifying, treating the pain in the first limb by;

implanting electrodes in a limb of the subject that is contralateral to the first limb, and

inducing driving of the electrodes to apply a pain-relieving current to the contralateral limb.

2. The method according to claim 1, wherein identifying the subject as suffering from pain in the first limb, comprises identifying a subject as suffering from pain in a limb that has been damaged by trauma.

3. The method according to claim 1, wherein identifying the subject as suffering from pain in the first limb, comprises identifying a subject as suffering from phantom pain in a limb that has been amputated.

4. The method according to claim 1, wherein identifying the subject as suffering from pain in the first limb, comprises identifying a subject as suffering from pain in a limb that is contralateral to a limb that has been amputated, and wherein implanting electrodes in the contralateral limb comprises implanting electrodes in a stump of the limb that has been amputated.

5. The method according to claim 1, wherein identifying comprises identifying the subject as suffering from neuropathic pain in the first limb.

6. The method according to claim 1, wherein identifying the subject as suffering from pain in the first limb, comprises identifying a subject as suffering from pain in a limb that has been damaged by disease.

7. The method according to claim 6, wherein identifying the subject comprises identifying a subject as suffering from pain in a limb that has been damaged by diabetes.

8. The method according to claim 1, wherein inducing driving the electrodes comprises inducing driving the electrodes from outside a body of the subject.

9. The method according to claim 8, wherein inducing driving the electrodes from outside the body of the subject comprises inducing driving the electrodes using a control unit that is coupled to an element that is coupled to the contralateral limb.

10. The method according to claim 1, wherein inducing driving the electrodes to apply the current comprises inducing driving the electrodes to apply a current having a frequency of 10 Hz to 100 Hz.

11. The method according to claim 1, wherein inducing driving the electrodes to apply the current comprises inducing driving the electrodes to apply a current having a frequency of 20 Hz to 100 Hz.

12. The method according to claim 11, wherein inducing driving the electrodes to apply the current comprises inducing driving the electrodes to apply a current having a frequency of 20 Hz to 40 Hz.

13. The method according to claim 11, wherein inducing driving the electrodes to apply the current comprises inducing driving the electrodes to apply a current having a frequency of 40 Hz to 60 Hz.

14. The method according to claim 1, wherein inducing driving the electrodes to apply the current comprises inducing driving the electrodes to apply the current for a therapy period having a duration of between two minutes and ten minutes.

15. The method according to claim 14, wherein inducing driving the electrodes to apply the current for the therapy period comprises inducing driving the electrodes to apply the current during 2-8 therapy periods per day.

16. The method according to claim 14, wherein inducing driving the electrodes to apply the current for the therapy period comprises inducing driving the electrodes to apply the current during 2-8 therapy periods per week.

17. The method according to claim 1, wherein inducing driving the electrodes to apply the current comprises inducing driving the electrodes to apply a current having an amplitude of up to 10 mA.

18. The method according to claim 17, wherein inducing driving the electrodes to apply the current comprises inducing driving the electrodes to apply a current having an amplitude of between 0.2 mA and 8 mA.

19. The method according to claim 18, wherein inducing driving the electrodes to apply the current comprises inducing driving the electrodes to apply a current having an amplitude of between 0.5 mA and 4 mA.

20. The method according to claim 1, further comprising detecting a myographic signal of the subject, wherein inducing driving the electrodes comprises inducing driving the electrodes responsively to the myographic signal.

21. The method according to claim 1, wherein implanting the electrodes in the contralateral limb comprises placing the electrodes within 1 mm of a tibial nerve of the contralateral limb.

22. The method according to claim 21, wherein placing the electrodes comprises placing the electrodes within 0.5 mm of the tibial nerve of the contralateral limb.

23. The method according to claim 22, wherein placing the electrodes comprises placing the electrodes within 0.3 mm of the tibial nerve of the contralateral limb.

24. The method according to claim 23, wherein placing the electrodes comprises placing the electrodes in contact with the tibial nerve of the contralateral limb.

25. The method according to claim 24, wherein placing the electrodes comprises inserting the electrodes into the tibial nerve.

26. The method according to claim 25, wherein inserting the electrodes into the tibial nerve comprises expanding a spring, the electrodes being coupled to the spring.

27. The method according to claim 1, wherein the electrodes are disposed on a housing, and wherein implanting the electrodes comprises implanting the housing on which the electrodes are disposed.

28. The method according to claim 27, wherein implanting the electrodes comprises placing the electrodes within 1 mm of the tibial nerve, between the nerve and the housing, such that when the electrodes are driven to drive the current into the tibial nerve, the housing reduces a current path from the electrodes away from the tibial nerve.

29. The method according to claim 27, wherein implanting the housing comprises implanting a housing that is at least partially flexible.

30. The method according to claim 29, wherein the housing includes flexible and rigid portions thereof, the portions being articulatably coupled to each other, and wherein implanting the electrodes comprises implanting the housing that includes the flexible and the rigid portions thereof.

31. The method according to claim 27, wherein implanting the electrodes comprises placing the electrodes within 1 mm of a tibial nerve of the contralateral limb.

32. The method according to claim 31, wherein placing the electrodes within 1 mm of the tibial nerve of the subject comprises injecting the housing into an ankle of the subject.

33. The method according to claim 31, wherein placing the electrodes within 1 mm of the tibial nerve of the subject comprises coupling the housing to the tibial nerve via one or more coupling elements that are coupled to the housing.

34. The method according to claim 33, wherein coupling the housing to the tibial nerve via the one or more coupling elements comprises coupling the housing to the tibial nerve via one or more spiral coupling elements.

35. The method according to claim 31, wherein placing the electrodes within 1 mm of the tibial nerve of the subject comprises inserting the electrodes into the tibial nerve.

36. The method according to claim 35, wherein inserting the electrodes into the tibial nerve comprises positioning the electrodes adjacent to the tibial nerve by moving the housing alongside the tibial nerve in a first direction, and, subsequently, inserting the electrodes into the tibial nerve by moving the housing in a second direction, the second direction being opposite to the first direction.