ReActiv8® vs. Spinal Cord Stimulators: Choosing the Right Neurostimulation Device

Chronic back pain can have a profound impact on daily life, making even simple activities feel overwhelming. When conservative treatments like physical therapy, medications, or injections fail to provide lasting relief, advanced therapies such as neurostimulation may offer hope. Two options that have gained attention in recent years are ReActiv8® Restorative Neurostimulation and Spinal Cord Stimulation (SCS).

Both therapies use electrical impulses to influence the nervous system and address chronic pain. However, they differ in their mechanisms, target conditions, and goals of treatment. If you’re exploring options to manage your pain, understanding these differences is key to choosing the right device.

Let’s break down how ReActiv8 and spinal cord stimulators work, who they’re designed for, and how to determine which may be the better fit for your needs.

Understanding Neurostimulation for Chronic Pain

Neurostimulation therapies deliver mild electrical signals to specific nerves or muscles to modify pain signals and improve function. These devices are implanted under the skin and controlled with an external programmer, allowing patients to adjust settings for optimal relief.

They are typically considered when pain has persisted for more than six months and has not responded to standard treatments.

What Is ReActiv8®?

ReActiv8® is a restorative neurostimulation system specifically designed to address mechanical chronic low back pain (CLBP) caused by multifidus muscle dysfunction.

The multifidus muscles are deep stabilizing muscles in the spine that support posture and control small spinal movements. Injury, repetitive strain, or nerve-related issues can cause these muscles to stop functioning properly, leading to instability and chronic pain.

ReActiv8 targets this problem by stimulating the medial branch of the dorsal ramus nerve, which activates the multifidus muscles and helps restore natural spinal stability over time.

How ReActiv8 Works:

• The system sends electrical pulses to the dorsal ramus nerve to trigger multifidus muscle contractions.

• These sessions last 30 minutes twice daily and are designed to retrain and strengthen the muscles.

• Over time, this can lead to long-term pain reduction and improved function.

Who May Benefit from ReActiv8?

ReActiv8 is designed for patients with:

• Chronic low back pain lasting more than six months.

• Evidence of multifidus dysfunction (often diagnosed via imaging or clinical testing).

• Minimal or no structural issues requiring surgical correction.

• Pain that worsens with movement or activity but improves with rest.

Unlike traditional pain therapies that only mask symptoms, ReActiv8 aims to restore function by addressing the root cause of instability.

What Are Spinal Cord Stimulators?

Spinal Cord Stimulation (SCS) is a well-established therapy for managing neuropathic pain, especially when caused by nerve damage or dysfunction.

SCS systems deliver mild electrical signals to the dorsal columns of the spinal cord, interfering with pain signals before they reach the brain.

How Spinal Cord Stimulators Work:

• A small device implanted near the spine sends electrical pulses via leads to the epidural space.

• These pulses create a tingling sensation (paresthesia) or use high-frequency/no-paresthesia waveforms to mask pain.

• Patients can adjust stimulation levels using an external controller.

Who May Benefit from SCS?

SCS is typically used for patients with:

• Neuropathic pain (burning, shooting, or electric shock-like pain).

• Conditions like failed back surgery syndrome (FBSS), complex regional pain syndrome (CRPS), or peripheral neuropathy.

• Chronic pain in the back, legs, or arms that has not responded to other treatments.

SCS is not designed to restore function but rather to block or mask pain signals, providing symptom relief.

Key Differences Between ReActiv8® and Spinal Cord Stimulators

Similarities Between the Two Devices

Despite their differences, ReActiv8 and SCS share some common features:

✅ Minimally Invasive Implantation
Both involve implanting a small device under the skin with leads placed in targeted areas.

✅ External Control
Patients use a handheld programmer to adjust therapy settings.

✅ Trial Periods
SCS typically offers a trial phase (temporary leads) to test effectiveness before permanent implantation. While ReActiv8 doesn’t have a “trial” period in the same way, careful patient selection and diagnostics are used to determine candidacy.

✅ Alternative to Chronic Medications
Both therapies offer a non-drug approach to managing pain, which is especially valuable for patients seeking to reduce opioid use.

Choosing the Right Therapy: Key Considerations

1. Type of Pain

• ReActiv8 works best for mechanical low back pain related to instability and muscle dysfunction.

• SCS is ideal for neuropathic pain caused by nerve damage or irritation.

2. Long-Term Goals

• If your goal is to restore spinal stability and reduce pain over time, ReActiv8 may be appropriate.

• If you need symptom control for nerve pain, SCS might be a better choice.

3. Diagnosis and Testing

Accurate diagnosis is crucial. Your physician may use imaging (MRI, ultrasound), electromyography (EMG), or physical tests to determine whether multifidus dysfunction or nerve-related pain is present.

4. Lifestyle and Preferences

• ReActiv8 requires a commitment to twice-daily sessions for optimal results.

• SCS offers continuous or adjustable therapy that can be tailored throughout the day.

Are There Risks?

Both devices are generally safe, but as with any medical procedure, there are potential risks:

• Surgical risks (infection, bleeding).

• Lead migration or device malfunction.

• In SCS, some patients experience uncomfortable paresthesia or reduced effectiveness over time.

• In ReActiv8, proper patient selection is critical to achieving success.

Working closely with a pain specialist or spine surgeon experienced in these therapies can help minimize risks and optimize outcomes.

The Bottom Line

Choosing between ReActiv8® and Spinal Cord Stimulation depends on your specific condition, the type of pain you’re experiencing, and your treatment goals.

• ReActiv8 focuses on restoring function and reducing mechanical back pain by retraining key spinal muscles.

• SCS is designed to mask neuropathic pain and provide ongoing symptom relief.

Both therapies can play a role in comprehensive pain management plans and may offer life-changing benefits for patients struggling with chronic pain.

If you’re considering either device, schedule a consultation with a specialist who can evaluate your case, explain the pros and cons, and help you determine the best path forward.