Vagus nerve stimulation is not new. It was identified back in the 1920’s as a nerve that can regulate the parasympathetic nervous system to release Acetylcholine neurotransmitter. In general, the autonomic nervous system is made up of these two opposing sides, kind of like a Ying and Yang:
There are several portable vagus nerve stimulators available. Medical grade vagus nerve stimulators will require a prescription and are typically more expensive than over the counter units. We leave the unit selection up to you.
Do NOT use if you have a pacemaker or defibrillator, are pregnant, or have a sick heart.
With low intensity stimulation as suggested, its likely using both ears are safe. However, the left ear is less likely to cause bradycardia or slowing of your heart. Limit stimulation to 30 minutes until you know how the stimulation effects you.
This non-invasive electrical stimulation of the “somatic” (i.e., external ear) afferent branch of the vagus nerve activates both “visceral” and “somatic” vagal projections in the brain and increases activities on the parasympathetic nervous system as described above.
The main areas we want to target are the cymba conchae, cymba, and cavum. If you are not able to attach the electrode to these areas, use the tragus or the antihelix of the ear. Please only stimulate one ear at a time. Remember you must use 2 electrodes to complete the circuit. We recommend placing both electrodes on one ear. If you are not able to, you can place one pad on the neck or upper back area with a pad instead. Stimulation wont work with just one lead/electrode.
As it is currently thought that the main problem with anosmia, parosmia, and brain fog is a result of autonomic dysfunction, perhaps adding external vagus nerve stimulation may be beneficial together with an SGB. In summary, if we activate the parasympathetic nervous system while downregulating the sympathetic nervous system, this may yield better results compared to what we have been trying. We are not advocating any particular unit to use.
Robert Groysman, MD, is a specialist in interventional pain management and anesthesiology who provides exceptional services at Southwest Pain Management (SPM) in Irving, Texas, for patients experiencing chronic pain. We focus on long term pain relief and improvement of function and quality of life at our practice. Our goal is not to just treat your pain, but also to get you back to doing the things you love. Some of my patients’ goals are being able to climb a flight of stairs to be able to sleep in the same room as her husband, being able to pick up your grandchild, being able to finish a round of golf, sitting in a boat to fish, and standing at a firing range for an hour or two.
If you are looking for someone who truly cares about treating your pain and getting up and about, he is the doctor for you. We combine injection therapy with medications and other treatments. We don’t offer sole opioid medication management. We treat migraines and chronic headaches, neck pain, back pain, and joint pain from arthritis. We also treat shoulder, knee, and hip pain. We also treat pain from disc herniations, sciatica, and facet joint spine pain. We have non-steroid options, including PRP, if you cannot have or don’t want steroids. We even offer a non-medication treatment for PTSD with a stellate ganglion block (SGB).
We use conservative pain management approaches wherever possible, including fluoroscopic and ultrasound-guided steroid injections and medications. We collaborate with specialists in other fields including chiropractors, rheumatologists, psychiatrists, neurologists, and spine surgeons, all of whom have contributed to improving the patient experience of chronic pain.
We do so much more than pain treatments. We prescribe low dose naltrexone for fibromyalgia, we successfully treat some of the long covid symptoms such as brain fog, loss of smell, and loss of taste. We offer medical massage covered by insurance.
He is a Diplomate of the American Board of Anesthesiology and American Board of Pain Medicine, and a proud member of the Texas Pain Society, American Society of Interventional Pain Physicians, and Spine Intervention Society.