Relief for Stroke Survivors with Shoulder Pain

Relief for Stroke Survivors with Shoulder Pain

By Ed Coghlan

Up to 85% of stroke survivors suffer from chronic shoulder pain and that pain often stops them from continuing their efforts to rehabilitate after their stroke.

When a stroke survivor can no longer move his or her arm, the muscles will atrophy. The shoulder will essentially separate and the pain from the shoulder will often cause them to drop out of rehabilitation.

Choices like opioids, short term joint injections and immobilization might help relieve the pain in the short-term but they don’t address the cause—how to settle down the axillary nerve.

Doctors are having some success with a recently FDA cleared device that treats chronic pain of a peripheral nerve origin. In fact, it was the first implantable neuromodulation device cleared for peripheral nerve pain.

The StimRouter was developed by Bioness, a southern California company that was founded by the legendary Al Mann, the entrepreneur and philanthropist who founded companies that focused on cardiac pacemakers, insulin pumps, spinal cord stimulators and cochlear implants.  Mann passed away earlier this year.

“The goal is to get the stroke patient back into rehab,” said Mark Geiger, Global Director of Marketing Implantables for Bioness. “By targeting the pain at its origin, we believe we have an answer for the chronic shoulder pain that plagues stroke survivors.


The StimRouter System
(Click to expand image)

The StimRouter is being marketed as a minimally invasive, long-term treatment option. No batteries are implanted. There’s less lead migration which is a big challenge for more invasive treatments.

Many pain physicians like what they see so far.

“This represents a paradigm shift in the management of post-stroke shoulder pain,” said Dr. Michael Sein, a rehabilitation physician at Weill Cornell Medicine in New York. “I like the ease of implementation which can be completed in an ambulatory setting as well as the significant levels of pain reduction that is achievable in patients that have failed to improve with prior therapy.

According to Dr. Sein, the traditional therapy has included physical therapy, medications and corticosteroid injections.

While the device was approved last year, the Company just launched the product in early 2016 and is still training pain and rehabilitation physicians around the country. Currently about 70 physicians are trained.

“That number is increasing by the month,” said Geiger.

The StimRouter is also approved for treatment of upper or lower limbs, entrapment syndromes, intercostal neuralgias and other peripheral injuries or disease.

Dr. Porter McRoberts of Fort Lauderdale, Florida is an interventional pain physician who has also used the device.

“100% of my implanted patients have had dramatic improvements in pain, said Dr. McRoberts. “One patient has even had complete resolution of her symptoms. I’ve been extremely happy.”

The Company hopes that for physical therapists and occupational therapists, the StimRouter may help these professionals successfully rehab more of the 800,000 Americans who suffer a stroke each year.

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Authored by: Ed Coghlan

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Sandy Miller

I had a thalamic hemorrhage and it left me with a condition known as Thalamic Pain Syndrome, which is chronic, horrific, stabbing, pain from my face down. I have such sensations on the left side of my face when I don’t take Neurontin, the generic does not help me at all, I’ve tried it several times, it’s much cheaper, but I have to have the name brand, but I feel like my face is heavy, pulled over to the side, heavy, like a slab of concrete is on my face, When I eat, the fork hits the side of my face because I can’t hit my face, all because of my stroke and my hands shake so bad, I can’t even print anymore, it’s just awfull.. I feel like I have something on me, water on a leg or, something crawling on me, and like my skin is burning and being ripped apart. I also had a deformed back in the shape of the letter “C”, it was Scoliosis after years of going to a pain clinic and receiving all kinds of injections and procedures….. how come they didn’t know I had Scoliosis, my husband and family kept wondering why one side of my body was so much lower than the other, we all assumed it was from the thalamic stroke. So I had to have spinal surgery from top to bottom. My arms and legs ache if I walk too much and I’m not one to give in, I try to keep goiing, but without my pain medicine, which only gives me a a little relief and not for long, but I appreciate any relief I can get, but if I am unable to get it since the government is telling doctors who hurts and who doesn’t anymore, I am in bed and will be in bed when they take my medication away from me and lying in bed with either a cold pack or heating pad for my back, yes it still hurts, they found a 90% blockage in my right coronary artery during testing for the spinal surgery, so had to wait a few months for back surgery. The junkies or people who are using prescription medication will still find theirs and get their fix, I just want some relief so I can do something around my house. I had my stroke at age 53 and my dad died of a massive stroke when he was 68. Well, I am 68 years old now and have grandchildren that I am unable to do the things I wish I could do like other grandparents do. My pain meds are the only reason I can exist. Like my retiring neurologist said to tell my doctor now, it’s like taking insulin away from a Type 2 diabetic patient, they don’t take it because they want to, they take it because they have to. This entire medical system with the government sticking their nose in everything we do is really getting… Read more »


I wonder it it is not a microstimulator. Microstim has had one available for over 20 years, at my recollection. But, I am sure it is no less costly than the $600 they were asking for the Microstim! It is all about who is paying for it (Obamacare) and the people involved in marketing. I saw mine at the American Academy of Pain Management meeting. Since they include practitioners from many backgrounds, the MD crowd, anesthesiologists, who seem to want a monopoly, never would know about them, conveniently.


Hrm, wondering if there were a similar option for an Inspire device (which has been developed to treat sleep apnea). I am not fond of the idea of having surgery to change batteries.