This article sheds light on the multifaceted nature of neuropathic pain associated with SCI, presenting an in-depth analysis of its prevalence, underlying mechanisms, and the array of current and future treatment options. Whether you're seeking insight into the latest therapeutic approaches, including nanomedicine and advanced pain management techniques, or exploring the biopsychosocial aspects of chronic pain management, our article thoroughly explores the state-of-the-art in neuropathic pain science.

It's not unusual for us to receive a call from a client with a spinal cord injury or a peripheral nerve injury who has been trying to use a handheld NMES (a form of Functional Electrical Stimulation) product and can't seem to produce a muscle contraction. The reason is likely because the muscle is denervated, and the NMES unit is unsuitable for that application. This article will explain why these units will not be suitable when denervated muscles are present, especially if it has been some time since the injury.

In physical rehabilitation, it is often the case that intensive effort is applied to exploit the natural ability of the body to adapt to the consequences of injury. This property, known as neuroplasticity is not yet fully understood but it at least represents hope that some functional recovery is possible in many cases. In many cases there will remain a functional deficit and ultimately we find ways to compensate for function that cannot be recovered.

The nervous system is a very complex, adaptable structure, that can be disrupted by illness or injury. Rehabilitation strategies to apply in a particular case obviously depend on the nature and extent of injury.

Clinicians might refer to an "upper motor" or "lower motor" lesion when discussing a particular case. What do these terms mean? In this article we review the meaning of these statements and the consequences for rehabilitation. Some of our electrical stimulation products relate to problems with the nervous system and may help to restore or compensate for loss of function following injury or illness. Which products are relevant to these types of lesions?

Let's start by reviewing some aspects of the nervous system.

Electrical Stimulation Therapy has established itself as a substantial tool in physical therapy. Applications such as Transcutaneous Electrical Nerve Stimulation (TENS) units and Electrical Muscle Stimulation (EMS) devices have demonstrated substantial effectiveness in improving overall function.
However, the application of electrical stimulation requires stringent safety measures. Assessing patient history, establishing clear treatment objectives, verifying equipment certification, and checking for any contraindications are essential steps to ensure safe and effective treatment. The presence of conditions such as pregnancy, wounds or scars in the electrode area, metal or active implants, and skin diseases may require careful evaluation before proceeding.
Proper patient education on equipment use, along with professional supervision, helps to maximise the benefits while minimising potential risks. Overall, when applied correctly and tailored to individual needs, electrical stimulation can significantly contribute to enhancing rehabilitation outcomes.

At Anatomical Concepts, we specialise in treating denervation - a condition where muscles lose their nerve supply. This can result from peripheral nerve injuries or certain spinal cord injuries affecting lower motor neurons. Untreated denervation leads to muscle atrophy, weakening muscles, and reduced ability to contract. However, RISE Stimulator, a device we use, can effectively treat denervation. By transmitting electrical signals directly to the muscle fibers, it bypasses the damaged nerve, preventing atrophy and muscle structural changes. This treatment method can normalize muscle tissue and increase muscle bulk over time. It's best to start soon after injury but can also help those with long-term injuries.

Functional Electrical Stimulation, commonly known as FES, has many practical applications. FES is a widely used, non-invasive treatment technique that applies electrical impulses to weak or paralysed muscles. The idea of using electricity to have a beneficial effect on the body is not new, but it is only with advances in technology in recent years are we starting to see the true potential of this approach for neurorehabilitation and healthcare in general.
The purpose of functional electrical stimulation is usually to generate a useful (functional) muscle contraction; often with the aim of improving function and movement but, depending on the type of stimulation used, an FES device can do much more than that.

In this article we review the topic of FES, some of it's applications and point to some of the devices offered by Anatomical Concepts.