Novel pain treatment gives patient new lease on life

Rosie Skinner was a woman on the move. She walked. She hiked. She ran long distances, even completing half-marathons and marathons.

Until one day, she couldn’t. 

Skinner had suffered from pain in her lower back for decades. In 2021, after moving to Moncks Corner from Indiana, Skinner, 76, sought the expertise of anesthesiologist Martin Burke, M.D., an MUSC pain management expert. 

For several years, Burke treated her with cortisone injections, medications and radiofrequency ablation procedures. Other treatments included referrals to physical therapy and home exercise programs.

Nothing worked. The pain had become unbearable and was stealing her mobility. “I could barely stand up straight, much less walk comfortably,” she said. 

 

In the summer of 2024, Burke told her about ReActiv8, a unique neurostimulator procedure that not only relieves pain but also restores muscle function and improves physical function in patients. He asked her if she would be interested in trying it. 

Skinner didn’t hesitate.

“I said, ‘Yes, let’s do it.’ I didn’t question him. I trusted Dr. Burke’s judgment and was willing to try anything as long as it got rid of my pain.” 

Her procedure was scheduled for that August. 

Burke had just begun using ReActiv8 on his patients whose conditions qualified them for the treatment with encouraging results. 

“Improvement has been profound,” Burke said. “This neurostimulator procedure satisfies two key goals: pain relief and functional improvement. It is the only treatment we have in our field that can fix the problem; it’s not just palliative.”

Burke said the device is unique in that it targets a specific cause of many patients’ low back pain: multifidus muscle dysfunction. The multifidus muscle runs along each side of the lumbar spine and is the key stabilizing muscle in the low back. Trauma, whiplash and strain can affect its function, increasing stress on the lumbar spine and often resulting in pain and muscle atrophy. 

“We can see this on an MRI and also tell if the muscle isn't functioning correctly, based on certain physical exam maneuvers that we do,” he said. 

ReActiv8, which consists of one battery and two wires and comes with a remote control, is implanted during a 45 to 60-minute outpatient procedure. Burke makes a 1-inch-long incision in the middle of the back and a 2-inch incision in the patient’s flank, where the battery is inserted under the skin.

The device is activated two weeks later. Patients are instructed to use the device twice daily for 30 minutes by putting the control device, which resembles a TV remote, over the battery site. This activates the wires, which prompt the muscle to contract, triggering what patients describe as feeling “like a deep massage,” Burke said. 

Over a few months, the muscle function begins to return, Burke said. “I’ve implanted hundreds of pain devices, but this neurostimulator procedure is the only one we have in our field that truly is restorative.” 

He is encouraged by long-term results that show significant improvement in patients who are implanted with the device. 

“Some of these patients have been in chronic pain for 25 to 40 years. Five-year data show that almost 70% of patients had eliminated or reduced their opioid medication, and about 80% had improved significantly to a level where they could resume daily activities they previously had been unable to do, whether it’s playing golf, participating in other sports or even simple things like standing long enough to make a peanut butter and jelly sandwich,” he said.

Implantation is considered permanent, but the device can be removed if needed. The neurostimulator procedure is not a first-line treatment, Burke said. It is reserved for patients whose pain and dysfunction have not responded to physical therapy, medications and, when appropriate, injections and whose conditions cannot be corrected surgically. 

Skinner was an ideal candidate. Nearly a year after her implantation, she has resumed her activities. 

“The ReActiv8 is a terrific little instrument, and it completely took away my pain,” she said. “My recovery time was so much better than anything I’ve tried, and thanks to Dr. Burke, I’m moving and walking so much more.”

And … she just bought a treadmill.