Apparatus and methods for managing pain uses separate varying electromagnetic fields, with a variety of temporal and amplitude characteristics, which are applied to a particular neural structure to modulate glial and neuronal interactions as a mechanism for relieving chronic pain. In another embodiment, a single composite modulation/stimulation signal which has rhythmically varying characteristics is used to achieve the same results as separate varying electromagnetic fields. Also, disclosed is an apparatus and method for modulating the expression of genes involved in diverse pathways including inflammatory/immune system mediators, ion channels and neurotransmitters, in both the Spinal Cord (SC) and Dorsal Root Ganglion (DRG) where such expression modulation is caused by spinal cord stimulation or peripheral nerve stimulation using the disclosed apparatus and techniques. In one embodiment of multimodal modulation therapy, the prime signal may be monophasic, or biphasic, in which the polarity of the first phase of the biphasic prime signal may be either cathodic or anodic while the tonic signal may be either monophasic, or biphasic, with the polarity of the first phase of the biphasic tonic signal being either cathodic or anodic.

A method of treating osteoarthritis includes an implantable stimulator generating stimulation sessions at a duty cycle that is less than 0.05 and applying the stimulation sessions by way of the central electrode and the annular electrode to a location within a patient that includes at least one of an acupoint labeled ST35, an acupoint labeled EX-LE-4, or a location on a line that intersects the acupoints labeled ST35 and EX-LE-4.

Devices, systems, and techniques are described for adjusting therapy parameters defining electrical stimulation therapy. An example system includes a stimulation generator comprising a voltage stack configured to provide a stack voltage based on a multiplier of a battery voltage and processing circuitry. The processing circuitry receives a first set of parameter values that use a first stack voltage of the voltage stack to provide a first electrical stimulation defining a first therapy. The processing circuitry also determines, based on a second stack voltage lower than the first stack voltage, a second set of parameter values that define a second electrical stimulation, the second set of parameters defining a lower amplitude of electrical stimulation. Additionally, the processing circuitry controls the stimulation generator to deliver the second electrical stimulation according to the second set of parameter values using the second stack voltage of the voltage stack.

In various embodiments electrical stimulators are provided for transcutaneous and/or epidural stimulation. In certain embodiments the stimulator provides one or more channels configured to provide one or more of the following stimulation patterns: i) monophasic electrical stimulation with a DC offset; ii) monophasic electrical stimulation with charge balance; iii) delayed biphasic electrical stimulation with a DC offset; iv) delayed biphasic electrical stimulation with charge balance; v) amplitude modulated dynamic stimulation; and/or vi) frequency modulated dynamic stimulation.

An example of a system includes a blood pressure modulation device and a controller. The blood pressure modulation device may be configured to deliver a therapy to chronically maintain blood pressure within a prescribed range. The blood pressure modulation device may include a neuromodulator configured to deliver neuromodulation energy to neural tissue in a spinal cord or near the spinal cord using a first parameter set. The controller may include analyzer circuitry configured to determine an actual or anticipated blood pressure demand event indicated for a blood pressure change, and therapy parameter adjuster circuitry configured to respond to the actual or anticipated blood pressure demand event by delivering neuromodulation energy using a second parameter set to change the blood pressure.

A blood pressure controlling apparatus includes an acquiring part configured to acquire biological information indicating blood pressure of a subject, a producing part configured to produce a frequency modulated pulse train on the basis of the biological information, and a supplying part configured to supply an electrical current on the basis of the frequency modulated pulse train, to an electrode attached on the subject. The electrical current stimulates baroreceptor afferent nerves of the subject.

During charging of implantable devices via inductive coupling, heat may be produced within the implantable device, so control of the charging may be desirable to reduce or avoid the risk of undesirable tissue heating. Exchanging parameters relevant for charging may prevent undesirable heating, but typically increase the complexity of the devices used. An implantable device is provided, for wirelessly receiving energy pulses, monitoring the energy storage, and transmitting a first sufficient energy signal if the energy storage exceeds a first maximum value. An associated energy transmission device is provided, for wirelessly transmitting a plurality of successive energy pulses transmitted at a first power level, pausing energy transmission immediately after the first sufficient energy signal is received, and subsequently resuming energy pulse transmission at the first power level if no further sufficient energy signal is received.

Apparatus and methods for managing pain uses separate varying electromagnetic fields, with a variety of temporal and amplitude characteristics, which are applied to a particular neural structure to modulate glial and neuronal interactions as a mechanism for relieving chronic pain. In another embodiment, a single composite modulation/stimulation signal which has rhythmically varying characteristics is used to achieve the same results as separate varying electromagnetic fields. Also, disclosed is an apparatus and method for modulating the expression of genes involved in diverse pathways including inflammatory/immune system mediators, ion channels and neurotransmitters, in both the Spinal Cord (SC) and Dorsal Root Ganglion (DRG) where such expression modulation is caused by spinal cord stimulation or peripheral nerve stimulation using the disclosed apparatus and techniques. In one embodiment of multimodal modulation therapy, the prime signal may be monophasic, or biphasic, in which the polarity of the first phase of the biphasic prime signal may be either cathodic or anodic while the tonic signal may be either monophasic, or biphasic, with the polarity of the first phase of the biphasic tonic signal being either cathodic or anodic.

This application is generally related to systems and methods for providing a medical therapy to a patient by tracking patient activity and adjusting medical therapy based on occurrence of different types of activities performed by the patient including user indicated activities inputted from an icon driven user interface of an external patient controller device.

Methods and systems for regulating nerve activity and/or treating conditions associated with disorder of blood glucose are disclosed. A method of downregulating activity by applying a high frequency alternating current electrical signal to a nerve in a subject is disclosed. A method of upregulating activity by applying a low frequency stimulation signal to a nerve in a subject is disclosed. A method of regulating nerve activity by applying a high frequency signal to a first nerve/organ and applying a low frequency stimulation signal to a second nerve/organ is disclosed. The application of the high frequency signal and the low frequency stimulation signal to separate nerves or nerve branches/fibers can be independent, simultaneous, concurrent, or in a coordinated fashion in therapy programs. Various signal parameters including the waveform, frequency, amplitude, active/inactive phases are described.