- 220 O'Connor Ridge Blvd., Suite 105, Irving, Texas 75038
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:
It is not necessary to spend thousands of dollars on invasive needle probe vagus nerve stimulators or expensive TENS units. This can be performed in our office over 15-30 minutes or even at home if you simply have a good and adjustable TENS unit. I’m talking about the ones that you can vary the milliamps (mA), pulse width, and frequency. Some units come with selectable “programs “and are preprogrammed for certain actions setups only. Those are not good for what we want to do here. Those units are for Electric Muscle Stimulation (EMS) even though they call themselves a TENS unit.
We like the "TENS 7000" because you can adjust the frequency, pulse with/duration of pulse, and intensity and its inexpensive, under $40 from most vendors. You can find it on Amazon or being sold on the web. You will also need 2 ear clips with a 2mm female attachment.
Do NOT use if you have a pacemaker or defibrillator, are pregnant, or have a sick heart.
With low intensity stimulation as suggested under 1.5mA, 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.
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.
Dr. DeLillo specializes in fluoroscopy-guided interventional pain management procedures, as well as in complementary, nutritional, and biobehavioral approaches to pain management. He believes strongly in a multi-disciplinary approach to pain management, working in collaboration with chiropractors, rheumatologists, acupuncturists, massage therapists, physical therapists, weight management professionals, psychiatrists, behavioral psychologists, neurologists, and spine surgeons.
Dr. DeLillo is an integral and highly-experienced member of the team at Southwest Pain Management, helping patients who suffer from chronic pain to finally find much-needed relief.
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