A history of pain treatments
This article accompanies our April cover story announcing the winner of the 2009 Test Engineer of the Year Award.
Rick Nelson, Editor in Chief -- Test & Measurement World, 4/1/2009 2:00:00 AM
Through the ages, the search for pain relief has taken on many variations—some bizarre and some worthy of further investigation. This timeline courtesy of St. Jude Medical Neuromodulation Division summarizes how the desire to relieve pain has existed since the time of earliest civilizations, and it shows how the application of electrical stimulation to nerves has evolved into innovations that make living with pain easier.
Thousands of years BC—The Sumerian and Assyrian civilizations used opium, and the drug is mentioned in Egyptian medical scrolls dating back to 1500 BC. Medical practitioners in ancient Greece discovered that electrical impulses emitted from electric eels in clinical foot baths relieved pain and improved blood circulation. Producing up to 600 V in a single discharge, electric eel therapy was particularly popular for treating arthritis.
500 to 1500 AD—Leeches were a mainstay in conventional treatment of pain and inflammatory diseases in the Middle Ages. Dioscorides reported that the torpedo fish could be applied to the skin to relieve headaches.
1745—The Leyden jar was invented. It was the first device able to store static electricity and was used, among other things, to treat pain.
1750s—Benjamin Franklin and others began to experiment with the earliest creations of batteries. The batteries sent electrical stimulation through the skin to the painful area.
Early 1800s—Morphine was first separated from opium by European chemists and was found soon after in the US, where it began to take the place of opium in patented pain medicines.
1831—British scientist Michael Farady discovered that an electric current can produce a magnetic field and that the reverse was also true. This observation served as the basis for neurostimulation.
1874—The cannabis plant, from which marijuana is made, became a well-regarded headache remedy by prominent physicians.
1882—The “Faradic Electrifier,” an early treatment with electricity, was advertised in the Boston Globe as one of the “Most Marvelous Inventions of the Century! All cases of Rheumatism, Diseases of the Liver, Stomach and Kidneys, Lung Complaints, Paralysis, Lost Vitality, Nervous Disability, Female Complaints are cured with the Electrifier!”
1898—Heroin, the newest opium derivative, was first produced commercially by Germany's Bayer Company. It was widely advertised as being at least 10 times as potent a painkiller as morphine with “none of the addicting properties.”
Late 1800s—Hot spring bathhouses were erected in England and the US to relieve pain, heal injuries, and prevent diseases. French scientist G. Gaiffe constructed an electrical nerve-stimulating device called the Gaiffe TENS (transcutaneous electrical nerve stimulation) unit, which had all of the basic components of a modern neurostimulation device. However, its low electrical output (estimated to be about 3 mA) made it ineffective for neurostimulation.
1900—More than 200,000 people in the US were estimated to be addicted to opium, which was used as a main ingredient in patented pain medicines. The US Congress passed a law in 1909 prohibiting the manufacture and sale of opium.
1915 to 1951—The Violet Ray Generator was introduced and tens of thousands were sold for home use over a 35-year period. Marketing literature claimed the device cured a wide variety of ailments including paralysis, wry neck, and writer’s cramp. In 1951, the FDA banned the manufacturer from claiming it provided medical cures.
1919—The Electreat, a TENS device, was patented by Charles Willie Kent and manufactured in Peoria, IL. An estimated 250,000 Electreats were sold during the following 25 years. The device operated on two D cell batteries and a mechanical inductorium. A roller was built in at the top to be applied to the skin, and plug-in sponge-pad electrodes were supplied. The Electreat was one of the very first high-output, battery-operated TENS units manufactured.
1939—Methadone was first synthesized in Germany in research efforts aimed at developing a new painkilling medication.
1944 to 1948—The first clinics devoted to the treatment of pain were established. They were often known as nerve-block clinics.
1965—Psychologist Ronald Melzack and physiologist Patrick Wall published a landmark paper on their gate-control theory of pain. They theorized that the body has gating mechanisms within the spinal cord that close in response to normal stimulation and open with intense or painful stimulation, allowing the signal to reach the brain.
1967—Neurosurgeon C. Norman Shealy was the first surgeon to begin implanting neurostimulators in humans for pain relief. By 1970, six patients had undergone this treatment.
1972—Dorsal column neurostimulators were first marketed to neurosurgeons in the US. These devices were later renamed spinal-cord stimulators.
1976—Advances in cardiac pacemaker technology provided the basis for the development of the first totally implantable neurostimulator.
1980s—The use of opioids administered directly to the spinal column via epidurals emerged as a treatment for chronic pain.
1991—The first prototype of a RF (radio-frequency) spinal-cord stimulation system is developed by Neuromed (now St. Jude Medical Neuromodulation Division) for the relief of chronic neuropathic pain.
1997—IDET (Intradiscal electrothermic therapy) was introduced as an investigative treatment for chronic low back pain. This procedure involves killing nerve fibers by heating a catheter positioned inside the spinal disc.
2002—The US Department of Health & Human Services reported that narcotic analgesics were involved in 16% of total drug-abuse-related emergency room visits for an estimated 108,320 visits in 2002. The 45 to 54 age group experienced the largest increase (298% since 1995).
2004 to 2005—The first rechargeable spinal-cord stimulation systems became available in the US. Using rechargeable technology similar to a cell phone, these devices represent the newest advancement in neuromodulation devices for the treatment of pain.
2008—St. Jude Medical Neuromodulation introduces the Eon Mini rechargeable neurostimulator to treat chronic pain of the trunk or limbs and pain from failed back surgery.
Part of this timeline comes from the Burton Report’s History of Neurostimulation, Part I and Part II.
For more information on pain treatment, visit www.PowerOverYourPain.com.
To see video demonstrations and animations related to the Eon Mini device, you can visit the Eon Mini media center.
Read about our 2009 Test Engineer of the Year, Eddie Abshire: "Test tenacity drives neurostimulator success."
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