New Device Treats Arthritis Pain with Heat

New Device Treats Arthritis Pain with Heat

Over the ages, people have tried all sorts of things to relieve pain from arthritis – from copper bracelets, snake venom and liniment oil to acupuncture, herbal teas and narcotic painkillers.

Some work. Some don’t.

Now along comes the Avacen 100, a medical device recently cleared by the U.S. Food and Drug Administration to be marketed for the temporary relief of joint pain associated with arthritis, as well as minor muscle aches, sprains and spasms.

“It worked very well for me,” says Gabrielle Farrell, a 67-year old resident of Santa Barbara, California who has suffered from arthritis for over a decade. “It is such a gentle, easy treatment. It’s just incredible.”

Image courtesy of Avacen Medical

Image courtesy of Avacen Medical

About the size of a bread box, Avacen uses dry heat to warm the palm of a hand. Users put their hand inside the device and rest it on a pad heated to about 106 degrees Fahrenheit.

In theory, warming the hand improves circulation throughout the body, reducing pain and inflammation non-invasively and without the use of drugs.

“They feel a slight amount of pressure because it is a vacuum chamber. They’ll feel pressure as it seals around the wrist, kind of like a blood pressure cuff,” said Thomas Muehlbauer, Chairman and CEO of Avacen Medical, the San Diego-based company that makes the device.

“It’s actually pretty comfortable. Most people will feel very, very relaxed. I’d say 95% of the people using our machine will say they feel warmer or that they feel so relaxed.”

Farrell says Avacen improves her sense of well-being and helps her sleep. She uses it for 30 minutes, twice a day, usually in the evening.

“When I do the machine in the evening, my sleep comes faster and it is definitely, definitely more restful,” she told National Pain Report.

Because Avacen is “substantially equivalent” to a similar device made in China that’s already been cleared by the FDA, the company was not required to do any studies to prove its effectiveness in treating arthritis. The FDA holds medical devices to a lesser standard than medication, which often require years of expensive clinical studies.

Avacen Medical’s website does have several testimonials from people (Farrell is among them) touting the machine – which sells for $2,495. Over 200 have been sold so far to clinics and patients.

“The therapeutic claims being made for this expensive device seem far-fetched to me,” said John Quintner, MD, a rheumatologist and pain medicine specialist in Australia. “Where is the evidence that increasing core body temperature can relieve pain?”

Farrell says she was also skeptical about Avacen when she started using it a year and a half ago. As a test, she stopped using it for a month and her pain returned.

“I stopped for awhile and the proof was that everything came back. A sharp pain in my fingers or stiffness. When I don’t use the machine, my fingers become very stiff. And I don’t play the piano well because I don’t have mobility in my fingers,” she said.

While inflammation has long been linked to chronic pain, the theory that blood circulation in the hands plays a role is relatively new. In 2013, researchers at Integrated Tissue Dynamics and Albany Medical College discovered that a small number of fibromyalgia patients had an unusual amount of extra nerve fibers in the capillary blood vessels of their palms. The researchers believe those extra nerve fibers act as valves, interfering with the flow of blood to muscles and organs throughout the body.

Fibromyalgia patients typically suffer from joint pain, deep tissue pain, fatigue, depression, headaches and lack of sleep. What causes that whole range of symptoms – which are difficult to treat, much less cure – has long been a mystery.

In a pilot study involving 14 fibromylagia patients who used the Avacen device twice a day, 93% reported a significant decline in widespread pain. Because of that and other anecdotal evidence, this week the company applied to the FDA for approval to market Avacen as the first medical device for the treatment of widespread pain associated with fibromyalgia. Someday it may also seek to have the device approved for treating migraines.

“We believe our mechanism of action is infusing heat into the circulatory system at an amount greater than the core body temperature,” said Muehlbauer. “It drives the warmer blood which has a reduced viscosity through the capillaries. The biggest benefit there is that we’re taking oxygen and protein to the deep tissues and we’re taking away waste. That may not have been happening, especially for people with fibromyalgia.”

Quintner would like to see more proof.

In the absence of scientific evidence to support the claims being made for the product, it may be best for consumers to heed this wise advice, let the buyer beware (caveat emptor),” he wrote in an email to National Pain Report.

Gabrielle Farrell says she has all the evidence she needs.

“It works very well for me.” she said. “I know I will be using the machine for the rest of my life because I don’t like pills. I think if you take too many pills, eventually you’re going to have problems.”

Authored by: Pat Anson, Editor

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Question: Where is the evidence that increasing core body temperature can relieve pain?

Answer: Waon Therapy raises core body temperature by approximate 1 degree C and studies show it can reduce pain.

Evidence: Matsushita K, Masuda A, Tei C. Efficacy of Waon therapy for fibromyalgia. Intern Med. 2008;47(16):1473-6. PubMed PMID: 18703857. Epub 2008/08/16. eng.

All effective new treatments are welcome.

I have found that moving from heat to cold has had a good impact on my pain. I suspect that hot vs. cold is very much an individual thing. I’ve even done both serially and that seems helpful, too.

Heat treatments for joint pain is an old form of treatments. Many people used to rely on such treatments. Good to see such treatment with modern mechanism.

Kathleen, good points. The difference between AVACEN and your examples is that we use a vacuum to prevent vasoconstriction.

From our FAQs:

Can’t I just put my hand into some very warm water?

The body has a thermoregulation system that protects it from too much external heat or cold. The key to this regulation process is the body’s ability to vasoconstrict (close) the heat exchange vascular networks; This happens when the hand is placed in very warm water. The AVACEN 100 methodology uses negative pressure to dilate (open) these networks in the palm so it can continue to infuse heat at a safe managed level.

The use of heat for treatment of pain has been around for centuries. There are many ways to get heat to those sore body parts including hot baths, whirlpools, saunas, showers, and those microwaveable hot packs described by Stephanie. The science has also been known for some time. In theory we cause an increase in circulation of the heated area which will subsequently reduce inflammation. Heat also produces analgesia. However these are short-term effects aimed at symptoms. Heat treatment is not a cure. It is an alternative to drug therapy, is extremely safe and can be very cheap.

Kathryn Ellis

I love my Avacen 100. I use it twice a day morning and night. I’ve had a condition in my lower back after a fall for 10 years. Inflammation builds and causes sciatica which is very painful. It also contributes to my migraine headaches Since I have been using my Avacen I do not have to take the medication I had been on for 10 years. I take my machine on my vacations. I will not be without it! I am also very fearful of dementia which in my family history. I believe my Avacen will prolong my good health!

Sue

In the south, women would hold their iced drinks to their wrists to cool off, as the blood was so close to the surface there, they felt it cooled their body. If this worked, it seems like warming the hands might do the same thing for the warming of the body. Then, what that advantage is I don’t know.

marty

what I wouldn’t give to try this on my freezing crippled hands!!

Stephanie

This isn’t news to me. I hurt much more during cold weather and use several microwave heating pads several times a day during the winter in addition to staying indoors with the heat on and more clothes and blankets. I even had my office thermostat set to 78 degrees. I don’t see the reason for an expensive device, although I’d still like to move to a warmer climate.

This is promising. Wonder if one can be developed in which we can insert our entire bodies.

krissy

Too bad those who desperately need this will never get a chance to try it. I just started a part time chat job and im on disability as i cannot live on 1200 a month, and gonna be dying hands and fingers hurt and are stiff and freezing all the time without working. Wish someday that those who have money would help those in need instead of keep throwing it on garbage giving to charities.