This article explores the origins and evolution of transcutaneous spinal cord stimulation (tSCS), tracing its development from early electrical stimulation experiments to its emergence as a practical, non-invasive therapy for pain and spasticity management. It explains how tSCS modulates spinal sensory circuits, outlines the scientific milestones that shaped the technique, and highlights its growing role in modern neurorehabilitation. The article also introduces Stim2Go, the first European-approved device for tSCS, and discusses how this versatile technology is bringing advanced spinal stimulation into everyday clinical and home-based rehabilitation.

Muscle atrophy, the wasting away of muscle tissue, is a significant and often debilitating consequence of nerve damage or spinal cord injury. A proactive approach using forms of Functional Electrical Stimulation (FES) offers a powerful alternative: stopping muscle atrophy before it even begins and preserving tissue health for the long term.

When a spinal cord injury causes lower limb paralysis, for example, the leg muscles can no longer be exercised and strengthened through conventional methods, affecting muscle mass, circulation, and more. In many of these cases, approaches such as FES Cycling might help, and we'll mention this in more detail below.

If the injury affects the "lower motor neurons," this loss of muscle mass can be particularly profound. In this case the nature of the damage to the nervous system results in "denervation" which means that over time, muscle is gradually replaced by fibrous tissue, collagen, and fat. In these cases, a more specialised form of FES can be used to restore muscle bulk and tissue quality.

Electrical stimulation is a popular and widely used approach for physical rehabilitation. When used for muscle strengthening, it is necessary to take into account the fact that electrical stimulation produces muscle contractions in a relatively inefficient way.

In this article, we take a brief look at muscle fibre types. Following a neurological insult, muscle fibre types undergo transformation, producing changes that affect the ability of muscles to do work. We examine the particular case of spinal cord injury and consider how this affects the effectiveness of electrical stimulation.

Approaches to combat fatigue are examined. Finally, we consider attempts being made to improve the performance of stimulators and produce consistent muscle contractions under all circumstances.

In this article, I'm going to look at some of these reasons why electrical stimulation devices, that are regulated medical devices, cost what they do. The price disparity between consumer TENS units and medical-grade devices may seem vast, but it is grounded in real, tangible differences. By demanding higher standards for quality, efficacy, and patient outcomes, medical electrical stimulation devices play a critical role in modern healthcare. Next time you encounter the steep price of a medical device, ask yourself—what’s the price of safety, innovation, and a clinically proven outcome?

Functional electrical stimulation (FES) Cycling is a well-researched modality with long-term benefits for those recovering from a spinal cord injury. Users can actively exercise the large muscles of the legs despite paralysis.[1][2]. Although there are some contraindications, it is a safe and effective technique for many and is used by hundreds of our clients who use these systems at home. After some 18 years of experience in the UK, we still find that this is a well-accepted and popular technique, with adoption primarily limited by the cost of the systems.

With the introduction of the new Stim2Go stimulator from Pajunk at the core of our UK FES bike offering, we’re unlocking exciting new possibilities thanks to its innovative and promising features.

In other articles, we have commented on particular features and benefits of the Stim2Go, including its ability to turn any passive-active bike into an FES cycling system. In this article, we're primarily focusing on applying tSCS within Stim2Go.

Rehabilitation technology is undergoing a revolutionary transformation, driven by innovative solutions that prioritise adaptability and personalised care. This article explores how cutting-edge advancements, like Stim2Go, redefine therapy by aligning with the natural dynamics of the human body. By shifting from traditional, one-size-fits-all methods to highly individualised approaches, we are entering a new era of recovery that holds profound implications for patients and clinicians alike.