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NET Therapy – Chronic Pain Management

The following article was written by a practitioner in America but there are many chiropractors trained in this therapy in Australia.  This type of therapy does not appear to have research papers that provide conclusive scientific evidence.  However when a therapy is created around an individual and their particular needs, it is difficult to set control values.

This therapy was developed in the 1980’s.  Since that time, many medical practitioners acknowledge that mental health, emotional wellbeing and the nervous system all need to be evaluated when creating a pain management plan.

NET Therapy With Dr. Mary Lou Rane: Recover and Heal Today

As an integrative health expert with a Ph.D. in nutrition and certification in Neuro Emotional Technique, Dr. Mary Lou Rane has worked with countless patients in healing their limiting beliefs and inner pains for over the last 30 years.

So many of us live with unexplained pain, tension, and stress for years without ever truly dealing with them. We learn to live with these burdens, letting them weigh us down in everything we do. This stops us from reaching our full potential and living our best lives, and no amount of medication or trips to the doctor seem to help.

Neuro Emotional Technique Therapy or NET Therapy tackles these unknown pains and stresses by dealing with the root emotional and physiological cause in the body. With NET Therapy, patients find themselves healed from headaches, general anxiety, body pains, self-sabotaging habits, and more, in a simple yet effective session that determines emotional and stress responses through muscle testing and tracing back the true root of your emotional stress.

Read on to learn more about what you can expect from an NET Therapy session.

What is NET?

NET or Neuro Emotional Technique is a type of therapy which focuses on healing the body and its stress-related responses by targeting the physiological foundations of those conditions.

Emotional responses have physiological foundations in the form of amino acid chains that are carried throughout the body. NET Therapy deals with these physiological components of our most stress-inducing and traumatic experiences, helping the mind and body heal from these experiences permanently.

Impactful or traumatic negative emotions and experiences leave behind these physiological marks on the body. These can impair both the mind and the body from ever truly healing, thus leaving you with unexplained stressors or physical pains until these emotions are addressed. Neuro Emotional Technique addresses what is known as the Neuro Emotional Complex, or NEC, the emotional imprints crippling your physiological function.

Simply put, NET treats stress-related physical and mental conditions by tracing them back to their physiological location in the body, and working on them there. When paired with other healing therapies, NET helps patients get over any existing psycho-emotional blocks, which are residue from traumatic past events. These blocks prevent the body from truly healing from any conditions it may be experiencing, as well as further aggravating existing conditions.

For more detailed information about Neuro Emotional Technique, I wrote I whole piece that includes a brief history of NET.

Key Benefits of NET: Why You Would Want It

How do you know when NET might be beneficial for you? Again, NET is best for those dealing with stored long-term emotional trauma, as NET helps patients release that trauma (or neuro-emotional complexes) and allow their body and mind to physically and psychologically heal.

Here are some warning signs that you may be experiencing stored traumas in the form of neuro-emotional complexes:

  • You have unexplained shoulder tension and headaches
  • You often feel overwhelmed
  • You burst out in tears at times
  • Your digestive system isn’t as reliable as it once was
  • You often experience exhaustion or fatigue
  • You have little to no motivation to engage in activities you were once passionate about
  • You have tons of unexplained physical discomfort or pain

Various studies have proven the effectiveness of Neuro Emotional Technique Therapy. Patients who undergo NET Therapy can expect improvements in conditions like:

  • Headaches
  • General anxiety
  • Self-sabotaging habits
  • Body pains
  • Organ dysfunctions
  • Phobias

But NET Therapy helps in more ways than just the physical. With NET, patients experience a variety of psycho-emotional benefits, such as:

  • Unlocking and reprogramming the subconscious to recover from any psycho-emotional blocks
  • Promoting your own understanding of what you need in relationships, allowing you to develop and maintain more fulfilling relationships with your friends and family
  • Understanding the sources of the limiting beliefs that are holding you back in your subconscious, and unraveling them from the inside out
  • Correcting any neurological imbalances caused by unresolved stress and its physiological effects, leading to significant reduction on stress, anxiety, and phobias

Patients who experience successful NET Therapy by proven professionals find themselves feeling renewed and revitalized, as if the weights on their shoulders have finally been removed. This gives patients a greater ability to live out the life they want to live and achieve their true purpose.

What To Expect During the NET Session: Step-By-Step Breakdown

So what exactly happens during the typical NET Therapy session, and what can you expect during this session as a patient?

While the small details may vary from practitioner to practitioner, the typical NET Therapy session begins with muscle testing, which is also known as manual muscle testing or applied kinesiology. Muscle testing is a method to uncover muscular, structural, and mental conditions. An easy way to understand muscle testing is to refer to the third Law of Motion: “For every action there is an equal opposing reaction.”

Muscle testing applies this idea to ailments afflicting the human body. This concept indicates that internal issues and stressors naturally lead to a muscle weakness. Through muscle testing, practitioners can locate where these issues may be by linking them with the meridian system found in traditional Eastern medicine, which finds the paths between various parts of the bodies.

The session begins with muscle testing and the NET idea of emotions and their specific physiological effects on the body to trace the patient’s exact stressor. For example, a patient may come in with a sore left knee that she had been dealing with for months with no known cause. This may be a sign of a NEC (Neuro-Emotional Complex).

The practitioner will use reflex points on the body to try to link the knee pain with any stress and tension that the body is holding onto. The patient will also be asked if they have any current problem or source of stress, whether at work, home, or with their relationships. Once this problem is identified, the practitioner will find a certain statement around the topic to make their tested muscle go weak.

In practice, this works with the practitioner asking the patient to raise their arm, and the practitioner pushing it down with their hand; this is to test the strength of the muscle. This is repeated several times as the practitioner goes through various statements, looking for the issue that may be causing the patient stress.

For women, one common issue is the feeling that they’re not enough — not enough as a mother, as a partner, as a friend, or as a woman. For this issue, the patient is challenged by being asked to say statements like, “I am a loving mother”, “I am fine just the way I am”, “I am beautiful enough and good enough as me”, all while muscle testing is applied.

This is repeated until a certain statement is found that causes the arm (or whichever muscle being tested) to fail. Once this occurs, the practitioner uses NET to find the emotions associated with that specific statement by linking that emotion to their pain or other symptoms.

Finally, the NET practitioner works with the patient to find the exact painful moment in their past where that negative emotion and limiting belief was created. With NET Therapy, these stuck emotions become slowly released, allowing the patient to recover from these limiting beliefs and heal from these long-term stressors.

Australian content

Research Paper

Stress reduction via neuro-emotional technique


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For people with chronic pain, flexibility and persistence can protect wellbeing

Chronic pain affects around one in five people and is considered “chronic” when it persists beyond the expected healing time, typically three months or longer.

Along with physical problems, chronic pain can impact a person’s daily activities, employment, lifestyle and mental health.

Doing things you love and having goals are fundamental for wellbeing because they give meaning and purpose. But pain can make doing the activities you enjoy psychologically, physically and/or emotionally very challenging.

Our new research shows the way a person with chronic pain responds to not being able to participate in the activities or goals they value can can impact their mental wellbeing – even more so than their pain levels.

Pain intensity vs interference

We surveyed more than 300 people living chronic pain (that wasn’t related to cancer) about their mental wellbeing, “pain intensity” and how much pain interfered with the everyday pursuits and activities that mattered to them.

(We differentiated chronic pain from cancer pain due to the differing prognoses and treatments available, and the unique psychological and social factors associated with cancer pain, such as concern about death.)

We found pain that disrupted daily life activities, rather than the intensity of the pain, posed the biggest threat to a person’s mental wellbeing.

When pain interferes with a person’s engagement in meaningful daily activities, it causes distress and decreases wellbeing.

Man's hands with arthritis
Pain stops some people doing the things they find meaningful, like going to work. Unsplash/Towfiqu Barbhuiy 

The research suggests it’s possible for people to find ways to maintain their mental wellbeing, even when their pain intensity is high, so long as they’re able to maintain aspects of life that are important to them, such as relationships and work.

People with pain find other ways of doing things

We found personal motivational traits – specifically, goal flexibility (adjusting goals in response to changing circumstances and setbacks) and tenacity (persistently striving to achieve a desired goal under difficult circumstances) – were associated with increases in mental wellbeing for people living with chronic pain.

Although flexibility and persistence were both associated with increased mental wellbeing, the capacity to flexibly adjust to setbacks or obstacles had the most significant positive effect in maintaining one’s mental wellbeing.

Read more: 1 in 5 Aussies over 45 live with chronic pain, but there are ways to ease the suffering

Flexibility appears to act as a protective factor against the impacts of pain interference on mental wellbeing, to a greater extent than personal tenacity or persistence.

There is often more than one way to modify or adapt an activity when difficulties arise. A walk on the beach with friends, for instance, may be adjusted to meeting at the beach for coffee to fulfil the same goal or value: social connectedness.

Focusing on people’s strengths rather than deficits

Psychological processes that can help people to live well in the face of long-term pain have long been overlooked. Research has traditionally focused on unhelpful thought processes that perpetuate or exacerbate mental distress. For example, pain catastrophising and repeated negative self-criticism.

Pain management and mental health are multi-faceted. Previous research has shown pain management should take into account physical factors (age, sleep, injury, disease) and social factors (employment, social support, economic factors).

Older man with walking stick walks next to small white dog
Research has tended to focus on the negative thought processes of people with chronic pain, rather than the positive. Shutterstock

Our findings add to this body of knowledge. For those living with pain, reappraising and adjusting meaningful life activities and goals, when needed, in response to setbacks or life challenges can help maintain mental wellbeing.

These findings can inform the development of psychological supports for people with chronic pain. In turn, these supports could identify internal strengths, resources, positive coping strategies, self-efficacy, hope and wellbeing – and promote psychological strengths rather than deficits.

Read more: Why we need to get creative when it comes to talking about pain

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Six Great Plant-Based Foods to Fight Nerve Pain

Six Great Plant-Based Foods to Fight Nerve Pain

By Dr. Bussell – March 30, 2021

If you’re living with nerve pain, there is a definite benefit to eating healthy, low-inflammatory foods. A plant-based diet offers abundant opportunities for healthier nerves and less pain.

What’s also great, is how easy it is to prepare simple meals at home, where you control the ingredients that go into your meals. The convenience of eating out doesn’t outweigh the risk of relying on restaurant kitchens to use foods or ingredients that will relieve rather than aggravate your nerve pain.

During National Nutrition Month and beyond, eat more of these six plant-based foods that are great for your health and help reduce nerve pain. Incorporate these into your diet every day in half or full cup servings, fresh or frozen. Eat them separately or mix up some appetizing salads. Bon appetit!

  1. Green and leafy vegetables. Broccoli, spinach and asparagus all contain vitamin B, a nutrient important for nerve regeneration and nerve function. Spinach, broccoli and kale also contain a micronutrient called alpha-lipoic acid that prevents nerve damage and improves nerve function.
  2. Fruits. Eat at least one fruit daily to help heal damaged nerves. Berries, peaches, cherries, red grapes, oranges and watermelon, among others, are loaded with antioxidants, which help to decrease inflammation and reduce nerve damage. Plus, grapes, blueberries and cranberries have been found to be full of a powerful anti-inflammatory compound called resveratrol.
  3. Zucchini. A type of summer squash, zucchini is actually a fruit. Like other fruits, it’s rich in antioxidants and, therefore, good for nerve cells. It’s also a good source of potassium, which promotes effective nerve transmission, and magnesium, which calms excited nerves.
  4. Sweet potato. This root vegetable offers several nerve health benefits: An abundance of vitamins A and C, which provides antioxidant protection for cells. Sweet potatoes also have natural anti-inflammatory compounds. Animal research has demonstrated that nerve and brain tissue has shown reduced inflammation after eating purple sweet potato extract. And the high fiber content of a sweet potato won’t spike your blood sugar because it causes starch to burn slowly.
  5. Quinoa. Although it’s commonly considered to be a grain, quinoa is actually a flowering plant that produces edible seeds. Once a staple food grown in the Andes Mountains for native people of Peru, Bolivia and Chile, quinoa has become a worldwide favorite, grown in more than 70 countries. Quinoa is a great source of potassium, which aids effective conduction of messages through nerves. It’s an excellent source of magnesium, phosphorus, manganese and folate. This superfood also contains protein, fiber, iron, copper and vitamin B6.
  6. Avocado. This unique fruit is full of healthy fats. Like quinoa, it has a healthy dose of potassium, which promotes effective nerve conduction. Avocados also help increase your body’s absorption of antioxidants.
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How to free yourself from anxiety, with Paul McKenna


Do you struggle with anxiety? For this episode of The Liz Earle Wellbeing Show, Liz chats to hypnotherapist and behavioural scientist Paul McKenna about how we can free ourselves from anxious feelings.

Paul guides Liz through different techniques, such as havening and freeze frame, to help us when we are feeling stressed out.

The episode also covers neuro-linguistic programming (NLP) and whether manifestation can help us hit our goals. Plus, Paul reveals how he first became fascinated with hypnotherapy and the science behind it.


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Facial Pain: Migraine, Trigeminal Neuralgia and more


This article and podcast has been created by

Heads Up 

Headache Specialists from the UK charity National Migraine Centre discuss everything migraine and headache related.

Dr Katy Munro and Dr Jessica Briscoe discuss ‘Facial Pain: Migraine, Trigeminal Neuralgia and more’ in the latest episode of our Heads Up podcast, with special guest consultant neurologist Dr Giorgio Lambru.

For more information:

Facial Pain Association

tna org uk

If you have any questions/comments or any topics you would like us to cover in our future episodes email:

WE ARE A CHARITY. Please help us keep going in the following ways:

  • Donate to help us continue to release new episodes:
  • Subscribe!
  • Spread the word via social media

Facial Pain Podcast

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Airing Pain 134 – Warwick Study Of Mental Defeat In Chronic Pain


What is mental defeat and does it have an impact on the experiences of those living with pain?

In this edition of Airing Pain, Paul Evans interviews the team at the Warwick Study of Mental Defeat in Chronic Pain (WITHIN Project) and research participants, as well as taking part in the study as a participant himself.

The study, which runs until May 2023, is investigating how mental defeat can influence pain sensation, sleep patterns, social activity, physical activity and the general health of individuals who have chronic pain.

Mental defeat is defined as the perceived loss of autonomy in the face of uncontrollable, traumatic events. In the context of chronic pain this can be explained as a loss of identity and self in relation to repeated episodes of pain.

Paul talks to the team about their experimental, lab-based study and the sleep-tracking survey, then undergoes the lab experiment himself. Afterwards, he discusses how he found it and the possible outcomes of the research. He also interviews other participants on their experience.

Research into mental defeat is in its early stages. It is hoped that the WITHIN Project will generate important information to help us further understand the influence that mental defeat has on distress and disability in chronic pain patients. This is essential listening for anyone wanting to know more about the research process, or wanting to participate.

Issues covered in this programme include:

Mental defeat, pain research, insomnia, psychological effects of pain, chronic pain, patient perspective, acceptance and commitment therapy, research participation, pain thresholds.

Click on below link to listen to the podcast

If you prefer to read the transcript please click on link to download PDF

Mental Defeat In Chronic Pain



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Chronic Pain Podcasts


Sometimes it can be extremely tiring and stressful reading detailed information about chronic pain, and the many ways to reduce the impact chronic pain has on the quality of life.

Many people prefer to listen to content rather than read. You can relax, close your eyes, and take in the spoken word via podcasts.

With that in mind, below are links put together by Annette Leonard, who lives with chronic pain herself.

This is not what I ordered

This is not what I ordered is a podcast by San Francisco psychotherapist and podcast host, Lauren Selfridge. The host conducts honest, humorous, and inspiring conversations with people to understand what it’s like to live with long term pain.

Chronically Chilled

We hope these podcasts can be a valuable tool for those experiencing chronic pain. Is there one you enjoy that we have missed? Let us know on our community Facebook group – you could be the one to introduce someone to their next favourite podcast! The link is here if you would like to join. Our community provides a place for people living with chronic pain to get support, tips, advice and support. We are better, together.

Trigeminal Neuralgia with Kelsey Darragh

Tune in as Kelsey shares…that she developed trigeminal neuralgia (TN) after two botched jaw surgeries.  That her surgeon gaslit her from the get-go after her surgeries, telling her it was all in her head and part of the healing process that she should be in such pain

click here for other podcasts to listen to

Continue reading Chronic Pain Podcasts

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Chronic Pain Online Tool

As an Association we are constantly looking for programs which can support sufferers of trigeminal neuralgia by utilising chronic pain online tools.

Below are details taken from a new program developed by St Vincent’s Hospital in Sydney called This Way Up.  The tool covers not only chronic pain but also wellbeing, mindfulness and anxiety.

Members can enrol for the chronic pain program by getting a referral from a GP.  Other services may requires paid subscription.

Disclaimer:- by publishing information about available programs we aim to provide information and education.  We do not recommend services, please consider your own circumstances and consult with your health care provider in respect of your care plan.


Chronic Pain Program

Learn practical strategies for managing chronic pain, and associated low mood and anxiety with our clinically-proven online program.


Chronic Pain at a Glance

The pain system involves all of our body’s systems and is a sensible and necessary system that functions to protect our bodies from a perceived threat. Sometimes the pain system can be ‘faulty’ and act in unusual ways. Chronic pain or persistent pain is pain that lasts longer than 3 months – beyond the healing period of tissue damage. This generally means that you experience pain despite having no new damage to the tissue. Pain does however impact on your ability to carry out your normal activities, whether these are at home or work, or in social or recreational settings. People with chronic pain will face different problems and barriers that prevent them from living their normal lifestyle, and stop them from achieving their goals.

Fortunately, you can learn to reduce the impact of chronic pain on your quality of life and many people who seek help get better. This program will teach you practical skills to tackle chronic pain and improve the way you feel.

About The Chronic Pain Program

This 8-lesson program takes a multidisciplinary approach to pain management and is based on an effective psychological treatment called Cognitive Behavioural Therapy (or CBT), which is designed to help you lessen the impact of pain on your wellbeing and quality of life.

It will teach you proven strategies for managing pain and show you how to work with your thoughts, emotions, and behaviours so you can make a positive change in how you feel.

The Chronic Pain Program was developed in conjunction with the multidisciplinary team at the St Vincent’s Hospital Sydney Department of Pain Medicine. The program has undergone clinical trials under the title ‘Reboot Online.

How to Get Started

To enrol in this program you will need to speak with your regular clinician (e.g., your GP, psychologist, or other health professional), and see if they can prescribe you this program and monitor you throughout your online treatment. You can download and take the Clinician Letter to your appointment.


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Neuromodulation – for Trigeminal Neuralgia

Our Vice President and Tasmania support group leader, Helen Tyzack, updated her group about neuromodulation for trigeminal neuralgia back in 2021.  She has provided the information she gathered, and we hope it may provide education and understanding about this treatment

Neuromodulation. In italics below I have added the contents of emails I previously sent to all those on my database. The first email was dated 22nd May 2021.

Yesterday it was exciting to watch and listen to the Webinar from the USA at 9am; chaired by the president of the Facial Pain Association of America Dr Jeffrey Brown interviewing a Member of their Medical Board, Dr Konstantin, (an expert in neuromodulation of facial pain).  Previously, thanks to member Peter, I had sent you the information for you to link in. I received an immediate response yesterday from Peter after the Webinar and I wonder how many others took up this excellent opportunity.

 This free opportunity was excellent but whether it was useful depends on your circumstances.  So, what did I learn?   In brief,

  • Neuromodulation is management, not cure, by a non-destructive change in our nerve activity – using a device
  • The device delivers non-painful sensations to the nerve.
  • Neuromodulation is minimally invasive
  • Neuromodulation can be facilitated inside our body or outside depending on need and circumstances.
  • Neuromodulation always involves the use of small devices. That is, the chemical modulation of our nerves by our medications does not count as neuromodulation.
  • Neuromodulation does NOT work for people with Typical Trigeminal Neuralgia and usually makes the pain worse.
  • Neuromodulation does work for people with neuropathic pain on the trigeminal nerve; it is most effective for those who have more or less constant continuing unpleasant pain. Some sufferers with Typical TN can, over time, develop this neuropathic continuous facial pain – either with or without the Typical TN (and its sharp shooting electric shocks).  The neuromodulation may (and may not) work for such people.
  • The process is for the specialist to test a potential patient with an external device over a week to 10 days making adjustments so that the sufferer can work out whether this neuromodulation process might be comfortable for them and reduce or remove the pain.  If all works well then, a device is implanted – and can be there for up to 15-18 years if need be.  If there a period of 6 months without the pain, the thinking is that the device can be removed, and neuromodulation is no longer required.
  • Usually, you do NOT get the ideal result first up and it needs reworking so should be seen as a work in progress.  Every person’s body is unique and therefore the device controls have to be uniquely set up.
  • Once a week the device needs to be recharged and this takes about 30-40 minutes
  • Neuromodulation also works well with sufferers of Occipital Neuralgia at the back of the head but does not work for migraines.
  • Who does neuromodulation treatments?  Find only the most experienced. Beware of someone who says they have 100% success – they may have only treated one or two people. The safest practitioner is the one who has already encountered complications with this process and has safely managed and solved the problems; the more complications (not of their own doing) they have safely coped with the better.
  • How long before you feel relief after the device is implanted? Rarely immediately and mostly hours, days or weeks later.  The message was to be open minded and not to panic if the response is not fast.  Allow time for your body to adjust

Main point:  Not every treatment will work for every person. No treatment will work all the time.

 I am fortunate at the moment not to be taking medications or in pain.  But I am mindful that the time will come when the pain returns. This Webinar was helpful because I now know more about my options for managing the pain.  In Tasmania where would I go for advice? I would be talking with members of the Trigeminal Neuralgia Associations of Australia’s Medical Advisory Board.

My second email was dated 10th August.

A few months ago, I told you I had listened to/watched webinars on the topic of Neuromodulation as a treatment for Trigeminal Neuralgia pain. Afterwards, I set out to determine if a specialist might come to Tasmania and talk to people in our Support Group and any others who might be interested.

Since then, I have been exchanging emails with Dr Nick Christelis, the President of the Neuromodulation Society of Australia and New Zealand. Recently, we talked by phone about the options, but a visit to Tasmania by a specialist to meet with TN sufferers is not on the cards.  However – 


Nick confirmed there was not a specialist in Tasmania, but he explained that he had used neuromodulation on patients with Trigeminal Neuralgia. He would welcome contact from any Tasmanian sufferers and be prepared to do an initial Telehealth consultation. His contact details are on the website: and his consultation and surgical location is within Warringal Private Hospital in the Melbourne suburb of Heidelberg, Victoria. Phone 1300 798 682.  If you read through this page and watch the video, then you will understand more about the services he offers.  His site has this to say about Nick:

Nick now practices 100% within the field of pain medicine. He is an interventional pain specialist combining a multidisciplinary team approach with advanced pain interventional techniques like nerve and joint blocks, epidural injections, radiofrequency ablation, pulsed radiofrequency, spinal cord stimulation and other advanced neuromodulation techniques.


Nick explained that a quarterly webinar is offered from within his organisation and can be accessed on the bellow link

Events | Ramsay Health Care

Please note that I have no experience of neuromodulation and no experience of Nick’s capabilities, so this email is not meant to be a recommendation. Rather, I am letting you know about this option, in case neuromodulation is a process which could improve your quality of life. 

If you decide to try this, I would be very interested to know what the process is and all the ins and outs. Not to mention whether it was useful for you and reduced, removed your pain. I am sure other sufferers would also be interested so please keep me posted. 

For facial pain sufferers in other mainland states, I recommend you read through the Neuromodulation Society of Australia and New Zealand website to find specialists close to you.

Extra Q&A after the recent webinar on neuromodulation pain management produced by the USA Facial Pain Association

1. Can a TENS unit applied somewhere help? Is the concept of neuromodulation similar to using a TENS unit? thank you.

The TENS is indeed one of the types of neuromodulation, and we do recommend trying it in patients who can tolerate placement electrodes onto painful regions. It tends to be much less effective than other neuromodulation approaches, but is definitely worth trying due to its low invasiveness. Keep in mind, that pain that does not respond to TENS may still be relieved by invasive neuromodulation with implanted devices.

2. Explain the relationship between neuromodulation and neuroplasticity?

Neuromodulation in many ways relies on neuroplasticity – we are trying to modify neural activity by adding neuromodulation signals, and neural plasticity plays a major role in cooling down hyperactive parts of the nervous system that are responsible for development of pain in the first place.

3. “Explain foramen ovale stimulation?” What’s the difference

I am not aware of “foramen ovale stimulation” – most likely, the procedure which is referred here is the stimulation of the trigeminal ganglion (Gasserian ganglion) that is reached through foramen ovale. This approach is known for many years but is rarely used, mostly because it is difficult to keep electrodes in that location as they tend to migrate over time. In principle, however, the trigeminal ganglion stimulation is a very effective approach to control neuropathic facial pain and may be considered if the pain involves several trigeminal branches at once.

4. Can it be used for a patient with a pacemaker?

Yes, neuromodulation can be used in presence of pacemakers and defibrillators. Your doctors need to be aware of these devices so the proper precautions may be made in choosing the device and its location in the body.

5. What is the success related to pain as a result of acoustic neuroma surgery/radiosurgery?

The mere presence of acoustic neuromas, the surgery to remove the tumor, and sometimes radiosurgery for the tumor may result in development of facial pain. Sometimes it presents as secondary trigeminal neuralgia and its treatment resembles trigeminal neuralgia management algorithm, but in some cases the patients develop trigeminal neuropathic pain or occipital neuralgia, and these conditions may great indications for neuromodulation.

6. Would it help with Geniculate Neuralgia?

The pain of geniculate neuralgia has not been investigated as an indication for neuromodulation, or at least I have not heard of it. The classical geniculate neuralgia may require either microvascular decompression or, more often, an open rhizotomy of nervus intermedius – this is what I normally recommend to my patients.

7. Once implanted, can the patient stop taking medications?

Yes, it is possible – but we usually start considering weaning pain medications only after the patients report symptomatic improvement from neuromodulation. Majority of patients are able to significantly reduce the amount of their pain-relieving medications as a result.

8. How much experience does Dr Slavin has with this? How many has Dr Slavin done?

Neuromodulation is a large part of my practice ever since I completed my fellowship in 1999 – and I do between 100 and 150 neuromodulation surgeries every year. Very few of these surgeries are done for facial pain as most facial pain patients I see end up having other interventions, including microvascular decompressions, percutaneous rhizotomy, radiosurgery, etc. Most neuromodulation surgeries in my practice are still done for pain in lower back and extremities, Parkinson disease and tremor, epilepsy and other functional neurosurgical conditions.

9. If I had an MVD without any pain relief, would this help?

Neuromodulation is generally recommended for trigeminal neuropathic pain and not for trigeminal neuralgia. If the patient’s typical trigeminal neuralgia did not improve with microvascular decompression, we would usually consider either repeating the decompression or proceeding with percutaneous interventions. If the pain is non-neuralgic but rather neuropathic in nature, neuromodulation would be an appropriate thing to consider.

10. Are the electrodes ever implanted into the brain and if so, where?

The brain stimulation for facial pain is usually reserved for patients with anesthesia dolorosa – the electrodes are placed either over the surface of the brain (so called motor cortex stimulation) or in the depth of the brain in the area of thalamus or brainstem (so called deep brain stimulation).

11. I am just finishing TMS therapy. It has not helped me. I like Dr. Brown’s suggestion to “adjust the magnet.” How can the Dr. find the correct “spot” for neuropathic pain?

It may be challenging to find the right spot for TMS. We usually recommend finding the face representation in the contralateral motor cortex or focusing stimulation at pre-motor area (which is used for treatment of depression).

12. Following left craniotomy for Trigeminal Schwannoma I have a mix of numbness on lower jaw but extremely sensitive and continuous pain on temple, cheek, and upper jaw. Is the neuro modulation compatible when both numbness and sensitivity are combined?

To answer your question, it would be important to find out whether the numbness is complete or partial. Stimulation of peripheral branches may help in case of partial numbness. Complete numbness may necessitate stimulation of the uppermost cervical spinal cord, the deep brain structures or the motor cortex.

13. Hi, I have a question from the webinar. Dr. Slavin described neuromodulation, if I understood correctly, as an option for trigeminal neuropathic pain but not trigeminal neuralgia and described TN2 symptoms as neuropathic pain. Just to clarify before I get my hopes up, is “trigeminal neuropathy” the same thing as TN2?

Trigeminal neuropathic pain is different from TN2 but there is certain overlap between them. As a matter of fact, about 20 years ago we published a theory that postulated a possible transition from TN2 to trigeminal neuropathic pain as a part natural history of this condition. Right now, we do not recommend neuromodulation for TN2, but use it routinely and frequently for trigeminal neuropathic pain.

The original webinar published by the FPA can be watched below –

Facial Pain Association Neuromodulation – YouTube

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Paracetamol Medication Availability

Our chronic pain sufferers have enough to deal with managing their medical condition.
This proposal if it goes ahead as outlined will seriously impact the availability of safe pain killers relied on by so many.
All chronic pain suffers need to be made aware and raise our voices how these proposals may impact them
A proposal to restrict the sale of paracetamol products like Panadol is likely “scaring” the millions of Australians who rely on these products to get through their daily lives, according to one advocacy group.

A committee of the Therapeutic Goods Administration (TGA) met on Wednesday to consider feedback from public consultation on limiting the sale of