Blog Entries from December 2014

The Impact of Neuropathic Pain on Productivity

Thursday, December 18th, 2014

A study published in the October 2014 issue of ClinicoEconomics and Outcomes Research looked at the impact of neuropathic pain on 624 subjects across 33 community-based physician practices.  For those suffering from neuropathic pain, the results will not be surprising.  In the workplace, neuropathic pain resulted in employment disability in 24% of subjects overall and increased to 37% for those having severe neuropathic pain.  When looking at impairment in performing regular daily activities outside of work, 57% of subjects reported activity impairment. Read More

Posted by NeuroMetrix in Chronic Pain

How can SENSUS detect when I’m sleeping? Why does it matter?

Thursday, November 13th, 2014

SENSUS can detect the orientation of your lower leg, thanks to a built-in piece of hardware, called an accelerometer.  If your leg is in a horizontal, or near-horizontal position for an extended period of time (1-2 hours or more), SENSUS will know that that you are most likely asleep.  If your device is set to automatically restart therapy every other hour, SENSUS will reduce the therapeutic intensity you experience during sleep by roughly 20%.  This reduction in intensity should allow you to retain the pain relief benefits of SENSUS, but minimize disruptions to your sleep as the device cycles in and out of active therapy sessions throughout the night.

If you are watching a little TV with your feet up and get up periodically, the sleep detection will not impact your normal therapeutic intensity level.  In any case, you will be able to tell whether your device is in sleep mode by looking at the blinking light on the front of the device.  The green light will blink once per second during a normal therapy session, but only once every five seconds while it is in sleep mode.  You don’t need to do anything special to get your device out of the reduced sleep intensity mode.  Once you are up and about for more than a few minutes, the device will automatically revert to your normal therapeutic intensity the next time it restarts a therapy session.  However, we do recommend that you remove your device for a period of time after waking up to prevent skin irritation.  When you put SENSUS back on and start therapy, the device will restart at your normal intensity. Read More

Posted by NeuroMetrix in SENSUS Operation

Wearable Medical Technology for the Treatment of Chronic Pain

Friday, October 17th, 2014

The development of consumer oriented wearable technology for fitness and health applications has exploded over the past 5 years. These devices monitor various physiological parameters such as activity, heart rate, and skin conductance with the intention of providing users with feedback that will improve their fitness level, sleep quality, and potentially certain aspects of their health. Although these devices can impact user behavior in important ways, they are not directly therapeutic. Furthermore, they tend to target the younger and healthier segment of the population. People with diseases such as diabetes, chronic pain, and sleep disorders are generally not benefiting from the availability of wearable technology.  
SENSUS has changed that. SENSUS is the first truly wearable medical technology for the treatment of chronic pain. Although the technology is based on transcutaneous electrical nerve stimulation (TENS), SENSUS has two distinct design elements that differentiate it from traditional TENS devices and define it as wearable technology. 
First is the wearable design. SENSUS is worn on the leg, just below the knee.  It’s comfortable, there are no wires and it may be covered by clothing. Beyond just being “worn”, wearable technology must integrate with the life of the user.  SENSUS does just that. Rather than therapy being a disruptive event, SENSUS is designed to integrate pain therapy into the user’s normal daily activity, including sleeping. Traditional TENS devices typically require the user to interrupt their normal activity each time a therapy is required. These traditional devices are not wearable, but rather they attach to the user, typically with wires, and lack the convenience and discreetness SENSUS provides.
Second, SENSUS minimizes the amount of interaction required between the user and the device. The SENSUS technology is auto-adjusting TENS which means the sophistication of the device controls many of the functions traditional TENS users must do manually. Not only does this provide convenience to the users, the technology is optimized to meet the specific stimulation needs of the individual user to optimize pain relief. Specifically, each SENSUS device is configured to the unique stimulation requirements of each user without the user having to manually control the device with dials. During a session the stimulation intensity will automatically increase to compensate for nerve desensitization that naturally occurs during TENS use. While wearing SENSUS, it will automatically start therapy every other hour. Lastly, during sleep, SENSUS automatically decreases the intensity to minimize disruption during sleep. Read More

Posted by NeuroMetrix in Wearable Technology

Benefits of Exercise for Neuropathic Pain

Monday, September 29th, 2014

Neuropathic pain can set off a vicious cycle for sufferers. Healthcare providers frequently recommend patients engage in more daily activity, including regular exercise, as a treatment for the underlying cause of their chronic pain, such as diabetes. Unfortunately, the pain itself may prevent the patient from being more active. A recent article in Frontiers in Cellular Neuroscience, “Benefits of exercise intervention in reducing neuropathic pain”, outlined the impact of exercise on peripheral neuropathy. While most people are aware of the positive impact that routine exercise can have on diseases such as diabetes, the article’s authors also review studies that show how exercise can preserve and promote function of the peripheral nerves and reduce the neuropathic pain sensations.  
SENSUS may be a good solution for people experiencing chronic pain who would like to be able to incorporate more activity into their daily lives. The device is a convenient, wearable electrical nerve stimulator that offers patients a fast-acting, non-narcotic chronic pain relief option. SENSUS has no side effects, such as lethargy, that may deter a user from exercise. Users may put the device on their leg under clothing and go about their daily activities, including the pursuit of fitness goals. Read More

Posted by NeuroMetrix in Painful Diabetic Neuropathy

Why does it take up to 15 minutes to get relief?

Tuesday, September 23rd, 2014

SENSUS employs transcutaneous electrical nerve stimulation, which is thought to work through the central nervous system. The device stimulates the sensory nerves that travel from the lower legs and feet to the brain through pathways in the spinal cord, prompting the body to release natural peptides (i.e., small proteins) called enkephalins that decrease the perception of pain. Although your central nervous system is releasing these native pain relieving chemicals, the process takes time to register an effect.  Some people will experience relief in a shorter amount of time, but users should allow up to 15 minutes for relief after starting a therapy session with SENSUS.   Fortunately, the diminished perception of pain may linger for up to an hour after the conclusion of a therapy session.  If your device is set to restart automatically, your next session will commence one hour after the prior session finishes for optimal pain relief. Read More

Posted by NeuroMetrix in SENSUS Operation

How Is Therapy with SENSUS Different From Other TENS Devices?

Tuesday, July 29th, 2014

With conventional TENS, the user must start and stop therapy manually. When activated, these devices run at a constant intensity level throughout the therapy session unless the user manually intervenes. When stimulating for a prolonged period at the same intensity level, the stimulation may become less effective as a result of nerve desensitization. This is when the nerves ‘get used to’ the stimulation. Also, conventional TENS devices carry warnings against use while sleeping.

SENSUS optimizes the user’s experience and pain relief in a number of ways. SENSUS will automatically restart therapy every other hour, so the user can put the device on and get relief throughout the day or night without having to think about it. Within a given therapy session, SENSUS automatically increases the stimulation intensity over the course of the session to compensate for nerve desensitization. This helps ensure that the stimulation the user is receiving is optimized for therapy. Lastly, SENSUS is the only TENS device approved by the FDA for use during sleep. This allows people suffering from sleep disruption due to chronic pain a TENS options for overnight pain relief. Read More

Posted by NeuroMetrix in SENSUS Operation

How Is the Design of SENSUS Different From Other TENS Devices?

Monday, July 21st, 2014

A conventional TENS device typically includes a control unit, wires and individual electrode pads.  These devices rely on the user to determine, and manually set, the stimulation levels through the various control dials on the device.  The user must also place multiple electrodes in specific locations and then connect the electrodes to the control units with lead wires.  These wires and individual electrodes inhibit the user’s movement and usually require the user to remain stationary throughout the entire therapy session.

SENSUS has a unique, pre-configured electrode that easily snaps directly onto the back of the device.  The device and electrode are then secured to the upper calf by a Velcro strap.  A single button press activates therapy at the therapeutic intensity level that was automatically calculated for the user prior to the first use.

SENSUS is low profile so that it may be worn discreetly under clothing and it is lightweight so it is comfortable to wear throughout the day or during sleep.  The user may go about their daily activities like walking the dog, working in the garden or sleeping through the night, while benefitting from pain relief SENSUS provides. Read More

Posted by NeuroMetrix in SENSUS Operation

How Can SENSUS Help Improve Your Sleep?

Friday, July 18th, 2014

Chronic pain and poor sleep are closely associated. As many as 50-70% of people with chronic pain also suffer from sleep problems. For example, about 50% of people with painful diabetic neuropathy, a common form of chronic pain in people with diabetes, have sleep disturbances or insomnia.
Chronic pain prevents people from falling asleep and maintaining restful sleep. At the same time, a chronic lack of sleep amplifies pain. The inter-relationship between chronic pain and poor sleep underscores the importance of treating both conditions in order to improve pain, sleep, health and quality of life.

Here’s how SENSUS can help. SENSUS may be used at bedtime to help you fall asleep, and throughout the night to help maintain high quality sleep. SENSUS provides pain relief by stimulating the nerves that carry normal non-painful sensations to your brain. Stimulation of these nerves changes the levels of certain natural chemicals in your nervous system that decreases your pain. SENSUS is the only transcutaneous electrical nerve stimulator approved by the FDA for use during sleep; so you can be confident that it is both safe and effective for you to use overnight. Read More

Posted by NeuroMetrix in Sleep Disorders

The Cycle of Chronic Pain and Disrupted Sleep

Wednesday, July 16th, 2014

Many people with chronic pain also suffer from disrupted sleep.  A recent article published in Neurology Reviews, Breaking the Cycle of Chronic Pain and Disturbed Sleep, looked at this relationship and the role that some pain medications may have in further disrupting sleep. Read More

Posted by NeuroMetrix in Sleep Disorders

How Can a Single SENSUS Device Provide Widespread Pain Relief?

Wednesday, June 25th, 2014

A single SENSUS device will often provide pain control in both legs, and in fact throughout the body. Although SENSUS is typically placed on the leg, transcutaneous electrical nerve stimulation is thought to work through the central nervous system. The optimal placement for SENSUS is on the upper calf, one to two inches below the knee. This placement allows the device to stimulate the sensory nerves that travel from the lower legs and feet to the brain through pathways in the spinal cord. The stimulation prompts the body to release natural peptides (i.e., small proteins) called enkephalins that decrease the perception of pain. Because these pain relieving chemicals are released from the central nervous system, the pain relief will typically be widespread, not just in the immediate area where the device is placed. 

For more information about how SENSUS works, please see Transcutaneous Electrical Nerve Stimulation: Mechanisms of Action.   Read More

Posted by NeuroMetrix in SENSUS Operation

The Association of Chronic Pain and Obstructive Sleep Apnea

Thursday, June 19th, 2014

Chronic pain and disrupted sleep are commonly associated and they share a circular relationship - pain disturbs sleep, and poor sleep worsens the pain response.  It is estimated that 28 million Americans have sleep complaints due to chronic pain syndromes. A recent article published by Medscape The Association of Obstructive Sleep Apnea and Chronic Pain looks at this bidirectional relationship between chronic pain and obstructive sleep apnea.   Read More

Posted by NeuroMetrix in Sleep Disorders

What is Wearable Medical Technology?

Wednesday, May 28th, 2014

Popular media references to the term “wearable technology” have increased dramatically over the past five years.   What is wearable technology, and more specifically what is wearable medical technology?

There is no technical definition of wearable technology, however most participants in the field probably agree that a wearable product must meet the following criteria:

  • The product must be worn on the user's body for an extended period of time.
  • The product should significantly enhance the user's quality of life, health or experience as a result of the product being worn.
  • The product must contain advanced circuitry, independent processing capability, and wireless or other connectivity.
Wearable medical technology is a wearable product that is designed to improve the user’s health.  This may be accomplished through monitoring of physiological and biological data (e.g., ECG, blood pressure), storage of critical medical information (e.g., medical record), or in the case of SENSUS, delivery of a specific therapeutic benefit such as pain control. Read More

Posted by NeuroMetrix in Wearable Technology

Associations Between Restless Leg Syndrome (RLS) and Diabetic Peripheral Neuropathy (DPN)

Tuesday, May 20th, 2014

Several published studies have described strong associations between restless leg syndrome (RLS) and diabetic peripheral neuropathy (DPN); for example Lopes et al. Diabetes Care. (   In a recent study published in 2013 by Sadosky and colleagues (, half of people with severe painful diabetic neuropathy reported having RLS.   The biological reason for the RLS and DPN association is unknown.  However, a study just published in the journal Neurology ( may shed some light on this important question.   Salminen and colleagues demonstrated peripheral hypoxia in patients with RLS.  This finding promotes the hypothesis that peripheral microvascular abnormalities may contribute to the development of RLS.  DPN is a microvascular complication of diabetes, and therefore the results reported in the Saliminen study raise the possibility that diabetic microvascular disease may cause both DPN and RLS.   This interesting hypothesis may suggest novel therapeutic approaches to both conditions. Read More

Posted by NeuroMetrix in Restless Leg Syndrome

The Underdiagnosis and Undertreatment of Painful Diabetic Neuropathy

Tuesday, May 13th, 2014

A study recently published in the Journal of the American Pharmacists Association ( assessed the prevalence of painful diabetic peripheral (PDN) and its impact on quality of life and patient satisfaction with their treatment.  The cross section study evaluated 71 subjects with Type 1 or type 2 diabetes (age 45 – 85 years).  Although 22% of the subjects reported a diagnosis of PDN from their physician, 54% reported symptoms of burning, aching, or tenderness in their hands, arms, legs, or feet.  Only 14% of these patients were receiving treatment for their symptoms.  Among subjects reporting symptoms of PDN, over half reported some level of interference with their sleep and a similar percentage stated dissatisfaction with their current treatment. The authors conclude that PDN may be substantially underdiagnosed and undertreated; which represents a potential opportunity for pharmacists to help patients with diabetes achieve a better quality of life. Read More

Posted by NeuroMetrix in Painful Diabetic Neuropathy

Links Between Obstructive Sleep Apnea and Diabetic Peripheral Neuropathy

Thursday, May 8th, 2014

Obstructive sleep apnea (OSA) is a common disorder that is prevalent in people with Type 2 diabetes.  It is characterized by upper airway instability during sleep, resulting in markedly reduced or absent airflow.  People with untreated sleep apnea frequently stop breathing during their sleep, which results in fragmented, low quality sleep. Diabetic peripheral neuropathy (DPN) affects over 50% of people with diabetes. If left untreated, diabetic neuropathies trigger foot ulcers that may require amputation and cause disabling pain in the form of painful diabetic neuropathy. An interesting study by Tahrani and colleagues published in the American Journal of Respiratory and Critical Care Medicine ( in 2012, evaluated the link between OSA and DPN from both clinical and pathophysiological perspectives.  The prevalence of DPN was 60% in subjects with OSA and only 27% in those without OSA.  The study identified increased nitrosative/oxidative stress and impaired microvascular regulation in OSA subjects.  These are pathophysiological processes that may damage peripheral nerves and thereby cause DPN.  The authors concluded by hypothesizing that OSA treatment, such as CPAP, may have therapeutic benefits in patients with DPN. Read More

Posted by NeuroMetrix in Sleep Disorders

Predictors of Long-term Use of Transcutaneous Electrical Nerve Stimulation

Monday, May 5th, 2014

A recently published prospective study by Koke and colleagues in Pain Practice ( evaluated predictors of long-term (> 6 months) use of transcutaneous electrical nerve stimulation (TENS) in patients with chronic pain.  In a multivariate analysis, independent predictors of long-term use were neuropathic pain, non-severe pain (<80 millimeters on 100 millimeter VAS) and positive expectations of pain relief success. The results of the Koke et al. study re-enforce the positive clinical results patients with neuropathic pain, such as painful diabetic neuropathy, have reported with SENSUS. Read More

Posted by NeuroMetrix in Chronic Pain

Central Nervous System Involvement with Diabetic Peripheral Neuropathy

Monday, April 21st, 2014

Diabetic Peripheral Neuropathy (DPN) causes chronic pain (painful diabetic neuropathy) and sensory loss that increases the risk of foot ulcers.  DPN has traditionally been viewed as a disease of the peripheral nerves.  However, several recent studies hinted at additional involvement of the central nervous system (CNS).  Now a novel study using Magnetic Resonance Imaging (MRI) by Dinesh Selvarajah and colleagues published in Diabetes Care ( demonstrates that patients with DPN have structural changes in the brain.  Specifically, the study found peripheral gray matter volume loss in regions of the brain associated with sensory and pain perception.  These findings may have far reaching implications for treating DPN.  If DPN leads to changes in the CNS, then early detection and prevention are critical to mitigate the risk of permanent and severe symptoms.  On the other hand, the brain has an amazing capacity to compensate for the focal loss of neurons (i.e., gray matter), which is called plasticity.  Pharmacological and neurophysiological techniques that enhance plasticity, which include transcutaneous electrical nerve stimulation, may therefore represent novel therapeutic approaches. Read More

Posted by NeuroMetrix in Painful Diabetic Neuropathy

Extending the Life of Your Electrode

Saturday, April 5th, 2014

Each SENSUS electrode should last two weeks before you need to use a new one.  But if you’re finding that they’re wearing out more quickly, here are a few simple things you can do to make sure you get the full life out of your electrodes:

  1. Cover the electrode with the liner when not in use.  This will help protect the gel from drying out and picking up dust and dirt, which can eventually interfere with the delivery of therapeutic stimulation by the device.
  2. Hydrate your electrode.  The gel on the electrodes is a hydrogel, which means that it will absorb and retain water.  The gel will naturally start to dry when exposed to air and used on skin (in drier months, your skin will absorb moisture from the electrode).  If you notice that the gel is no longer tacky enough to stick to your skin, remove it from the device and run it under water for 10-20 seconds and let air dry.
  3. Hydrate your skin.  For some individuals, the gel of the electrode adheres particularly well to their skin (and may even begin to separate from the electrode).  If you find that this happens to you, applying a light moisturizer 30 minutes prior to using SENSUS may help prevent this from occurring; be sure to let the moisturizer absorb fully into the skin.
  4. Storage: When not in use, store at room temperature in a location away from direct sunlight.
Read More

Posted by NeuroMetrix in SENSUS Operation

Taking Care of your Skin

Tuesday, March 25th, 2014

Keeping up with good skin care practices is very important when using the SENSUS device.  Our skin needs to be hydrated and must be allowed to breathe to stay healthy; SENSUS users should pay close attention to the area under the SENSUS device, particularly if using overnight or for multiple therapy sessions during the day.

Take breaks to let your skin breathe:  Take the SENSUS device off when you’re not using it.  If wearing overnight, be sure to remove the device for at least 3-4 hours in the morning.  If you ever feel your skin becoming itchy under the device, remove it until the itching subsides.  If at any point you develop skin irritation from using SENSUS, always wait until your skin has fully healed until using it again in the same location.

Read More

Posted by NeuroMetrix in SENSUS Operation

Managing your Pain: Using a Pain Diary

Thursday, March 20th, 2014

Pain is almost impossible to ignore when it’s present, but sometimes easy to forget when it’s gone.  Sometimes small changes that might not be noticeable from day to day can have big effects over longer periods of time.   Using a diary to rate your daily pain levels is a simple and effective way of helping you track your pain over time and learn what is most helpful for you in relieving your pain.

A simple pain diary like the one here will only take a couple of minutes a day to complete, and you’ll find that having this information to share with your doctor will be invaluable in determining the best therapeutic techniques for you in managing your pain.

Read More

Posted by NeuroMetrix in Chronic Pain

Patient Access to SENSUS is Substantially Increased

Monday, February 17th, 2014

NeuroMetrix has recently formed a distribution partnership with DJO Global, a leading manufacturer and distributor of electrical stimulation and orthopedic products.  DJO Global's direct sales force will promote SENSUS to pain management, podiatry, endocrinology, internal medicine, primary care and neurology clinics.  These efforts will increase the awareness of SENSUS among physicians and provide patients with greater access to this novel pain relief option. Read More

Posted by NeuroMetrix in SENSUS Updates

SENSUS may help improve sleep quality for those suffering from nighttime chronic pain

Friday, January 17th, 2014

SENSUS is the only transcutaneous electrical nerve stimulator that is FDA cleared for use during sleep. With the addition of the newly introduced continuous therapy mode, SENSUS can now be set to automatically start a therapy session every other hour to help control pain while you sleep.   Read More

Posted by NeuroMetrix in SENSUS Operation