This Wearable Device Can Reduce Chronic Pain, No Drugs Required

NEUROMETRIX
NEUROMETRIX

There are no easy treatment options for people with chronic pain. Opioid painkillers like Vicodin and OxyContin can help, but they’re highly addictive and come with a significant risk of overdose. The current epidemic of opioid overdoses (from both prescription drugs and heroin) in the U.S. may be the country’s worst drug crisis ever, killing more than 52,000 people in 2015 alone. Yet some scientific reviews have found that opioids may not even be that effective in the long term.

There are ways to combat chronic pain without pills, though, and a Boston-area technology company called NeuroMetrix is trying to bring drug-free pain relief to the masses, no prescription required. Its Quell electrical stimulation band (available on the FSA Store) is designed to reduce chronic pain in regular users, reducing medication use in the process.

The Quell device, which is about the size of a thin wallet, is designed to be strapped to your upper calf—the back of your calf has plenty of nerves for the device to work on—with a stretchy fabric band, much like the workout armbands that hold your smartphone or MP3 player while you run. When you turn the device on, it delivers low-level electrical stimulation to your leg for 60 minutes, then turns off for 60 minutes, then begins the cycle again for however long you wear the band.

One theory scientists use to explain pain perception, called gate control theory [PDF], hypothesizes that nerve fibers can only carry so much information to the brain, and activating the types of nerve fibers that respond to pressure and vibration rather than acute pain can inhibit the transmission of pain signals, effectively “closing the gate” between your brain and those nerves so pain messages can’t pass. According to this idea, the electrical stimulation provided by devices like Quell can block nerves from transmitting pain signals to the brain. (The same idea has been used to explain acupuncture’s pain-relieving properties.)

Opioid medications mimic the effects of the brain’s natural opioid peptides, like endorphins. (The word endorphin actually means “the morphine within.”) While at-home electrical stimulation devices called Transcutaneous Electrical Nerve Stimulation units (or TENS machines) already exist, they work much like opioid drugs, by stimulating endorphin production. Quell works slightly differently—by activating the production of another type of naturally produced opioid peptide called enkephalins.

“Enkephalins are not endorphins, but they act in a similar way,” according to NeuroMetrix founder Shai Gozani, who has a Ph.D in neurobiology as well as a medical degree. When you take opioids for a long period of time, your tolerance for endorphins and the opioid drugs that mimic them can increase. “There are no drugs that mimic enkephalins,” Gozani says, which is helpful both from a drug-tolerance perspective and because if you’re already taking painkillers, Quell provides a different kind of relief on top of what you’re already feeling from the medication. Even if Quell doesn’t make your pain go away entirely, it can work in conjunction with your meds so that you don’t need quite as many prescription painkillers to get through the day.

NeuroMetrix

While Quell only attaches to your leg, the influx of enkephalins provides pain relief throughout the body. The company recommends it for joint pain, lower back pain, leg and foot pain, and fibromyalgia. I suffer from chronic back pain, but it’s not concentrated in my lower back, so I was dubious as to whether the device would work for me. In the interest of scientific inquiry, I tested Quell on myself for Mental Floss.

The device turned out to be incredibly simple to set up. You just need to slip the unit into the band and snap the electrodes—which come attached to a long paper strip with four squares of conductive gel—onto the inside. You wrap the electrode strip around your calf using the band, then open up the mobile app. Through the app, you can calibrate the level of the vibrations, rate your pain for that day, and start or stop therapy sessions. (You can control Quell using the button on the device itself rather than the app, but it’s much easier on your phone.)

When you turn it on, Quell delivers electrical stimulation in hour-long sessions, but NeuroMetrix recommends that you do several sessions a day to get the full effect. I tested it out for several months, typically wearing it just before bed and while I slept.

Though the words “electrical stimulation” may make you think of shocks, Quell feels more like a little vibration. Ideally, the sensation should be just short of noticeable—when I sat very quietly, I could sometimes identify the tingle of the electric current, but barely, and when I was up and moving, I couldn’t feel it at all. This is both a strength and a weakness of the product, though. On the one hand, you can go on with your normal life without feeling like you’re being zapped. On the other hand, more than once, I tried to take off the band without realizing that it was in the middle of a treatment cycle and gave my fingers an unpleasant shock (not exactly painful, but not enjoyable either). Occasionally while asleep, I accidentally dislodged the band, cutting short my treatment. And I found that in my tossing and turning at night, I managed to stretch out the fabric band considerably, making dislodging it much more likely.

Quell doesn’t make pain disappear completely. I still have back pain daily, even while wearing the device. It doesn’t work for my knee pain, either. But while the device doesn't eliminate my back pain completely, it does make the pain more manageable. I found that it relaxed my muscles, relieving some of the tension that builds up around the spot where I feel the most pain. After I had technically tried Quell for long enough to review it, I continued to use it nightly. I even shelled out $82 for a three-month supply of new electrodes.

NeuroMetrix

There’s a good amount of science to back of NeuroMetrix’s claims about Quell, which is FDA-approved as an over-the-counter pain-relieving device. In a a peer-reviewed study in the Journal of Pain Research, more than 80 percent of participants felt an improvement in their pain after two months of use. Around 67 percent were able to reduce their medication usage.

Chronic pain is far from a rare problem, and better options for pain relief that don’t involve pills could make a significant difference. The CDC says that as many as one in four patients taking opioid painkillers long-term becomes addicted. And there are plenty of people who need pain relief. According to the National Institutes of Health, more than 11 percent of the U.S. population (25.3 million adults) suffers from daily chronic pain, meaning pain that has lasted more than three months or, in the case of an injury, when it lasts beyond when the tissue itself has healed. One study estimates that 28 million people in the UK suffer from some kind of chronic pain, often related to arthritis, rheumatism, or back and neck problems.

Most TENS units already on the market aren’t exactly user-friendly compared to Quell. The type of pain relief they provide is localized, so you have to figure out where to place the electrodes for your specific type of pain and deal with interfaces and settings that might as well require a nursing degree to comprehend. And you can’t use them while you sleep, according to the FDA, even though for many people, chronic pain interferes with their ability to snooze.

Quell uses higher-frequency stimulation for longer periods of time than other devices, which is what produces the enkephalin effect. “You’re basically blocking the effect of the pain signals as they come into the spinal cord, decreasing the number of pain signals that come into the brain,” Gozani says. Since not as many pain signals make their way to the brain, you perceive less pain overall. It takes 20 to 40 minutes of high-frequency stimulation (80 to 100 pulses per second, in this case) for the body to begin producing enkephalins, but when you wear the band for several hours per day, it produces more widespread, longer-lasting pain relief than if you used a TENS unit to give yourself a 30-minute rush of endorphins.

It’s also just easy to use. While the $250 Quell starter kit is more expensive than what you’d pay for some TENS units (they range from $30 to $500), the simplicity of the design alone is worth the price. It only takes a second to put on and control, and you can wear it whenever and wherever you want. You can’t exactly sit around in your cubicle or go for a run while hooked up to a bunch of different electrodes, but it’s easy enough to wear a Quell band under pants while walking around. It’s also much more powerful: NeuroMetrix estimates that Quell is five times more powerful than the average TENS device, and unlike the others, it’s approved to use when you sleep. (The device monitors your movements and reduces power to 80 percent when it senses you’re asleep.)

Quell may not work for everyone, and it may not eliminate your pain completely. But even a little relief can be worth it if you’re in constant pain.

Buy it here using your FSA funds.

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12 Creative Ways to Spend Your FSA Money Before the Deadline

stockfour/iStock via Getty Images
stockfour/iStock via Getty Images

If you have a Flexible Spending Account (FSA), chances are, time is running out for you to use that cash. Depending on your employer’s rules, if you don’t spend your FSA money by the end of the grace period, you potentially lose some of it. Lost cash is never a good thing.

For those unfamiliar, an FSA is an employer-sponsored spending account. You deposit pre-tax dollars into the account, and you can spend that money on a number of health care expenses. It’s kind of like a Health Savings Account (HSA), but with a few big differences—namely, your HSA funds roll over from year to year, so there’s no deadline to spend it all. With an FSA, though, most of your funds expire at the end of the year. Bummer.

The good news is: The law allows employers to roll $500 over into the new year and also offer a grace period of up to two and a half months to use that cash (March 15). Depending on your employer, you might not even have that long, though. The deadline is fast approaching for many account holders, so if you have to use your FSA money soon, here are a handful of creative ways to spend it.

1. Buy some new shades.

Head to the optometrist, get an eye prescription, then use your FSA funds to buy some new specs or shades. Contact lenses and solution are also covered.

You can also buy reading glasses with your FSA money, and you don’t even need a prescription.

2. Try acupuncture.

Scientists are divided on the efficacy of acupuncture, but some studies show it’s useful for treating chronic pain, arthritis, and even depression. If you’ve been curious about the treatment, now's a good time to try it: Your FSA money will cover acupuncture sessions in some cases. You can even buy an acupressure mat without a prescription.

If you’d rather go to a chiropractor, your FSA funds cover those visits, too.

3. Stock up on staples.

If you’re running low on standard over-the-counter meds, good news: Most of them are FSA-eligible. This includes headache medicine, pain relievers, antacids, heartburn meds, and anything else your heart (or other parts of your body) desires.

There’s one big caveat, though: Most of these require a prescription in order to be eligible, so you may have to make an appointment with your doctor first. The FSA store tells you which over-the-counter items require a prescription.

4. Treat your feet.

Give your feet a break with a pair of massaging gel shoe inserts. They’re FSA-eligible, along with a few other foot care products, including arch braces, toe cushions, and callus trimmers.

In some cases, foot massagers or circulators may be covered, too. For example, here’s one that’s available via the FSA store, no prescription necessary.

5. Get clear skin.

Yep—acne treatments, toner, and other skin care products are all eligible for FSA spending. Again, most of these require a prescription for reimbursement, but don’t let that deter you. Your doctor is familiar with the rules and you shouldn’t have trouble getting a prescription. And, as WageWorks points out, your prescription also lasts for a year. Check the rules of your FSA plan to see if you need a separate prescription for each item, or if you can include multiple products or drug categories on a single prescription.

While we’re on the topic of faces, lip balm is another great way to spend your FSA funds—and you don’t need a prescription for that. There’s also no prescription necessary for this vibrating face massager.

6. Fill your medicine cabinet.

If your medicine cabinet is getting bare, or you don’t have one to begin with, stock it with a handful of FSA-eligible items. Here are some items that don’t require a prescription:

You can also stock up on first aid kits. You don’t need a prescription to buy those, and many of them come with pain relievers and other medicine.

7. Make sure you’re covered in the bedroom.

Condoms are FSA-eligible, and so are pregnancy tests, monitors, and fertility kits. Female contraceptives are also covered when you have a prescription.

8. Prepare for your upcoming vacation.

If you have a vacation planned this year, use your FSA money to stock up on trip essentials. For example:

9. Get a better night’s sleep.

If you have trouble sleeping, sleep aids are eligible, though you’ll need a prescription. If you want to try a sleep mask, many of them are eligible without a prescription. For example, there’s this relaxing sleep mask and this thermal eye mask.

For those nights you’re sleeping off a cold or flu, a vaporizer can make a big difference, and those are eligible, too (no prescription required). Bed warmers like this one are often covered, too.

Your FSA funds likely cover more than you realize, so if you have to use them up by the deadline, get creative. This list should help you get started, and many drugstores will tell you which items are FSA-eligible when you shop online.

10. Go to the dentist.

While basics like toothpaste and cosmetic procedures like whitening treatments aren’t FSA eligible, most of the expenses you incur at your dentist’s office are. That includes co-pays and deductibles as well as fees for cleanings, x-rays, fillings, and even the cost of braces. There are also some products you can buy over-the-counter without ever visiting the dentist. Some mouthguards that prevent you from grinding your teeth at night are eligible, as are cleaning solutions for retainers and dentures.

11. Try some new gadgets.

If you still have some extra cash to burn, it’s a great time to try some expensive high-tech devices that you’ve been curious about but might not otherwise want to splurge on. The list includes light therapy treatments for acne, vibrating nausea relief bands, electrical stimulation devices for chronic pain, cloud-connected stethoscopes, and smart thermometers.

12. Head to Amazon.

There are plenty of FSA-eligible items available on Amazon, including items for foot health, cold and allergy medication, eye care, and first-aid kits. Find out more details on how to spend your FSA money on Amazon here.

Mental Floss has affiliate relationships with certain retailers and may receive a small percentage of any sale. But we choose all products independently and only get commission on items you buy and don't return, so we're only happy if you're happy. Thanks for helping us pay the bills!

The 20 Most Valuable Companies in the World

The Apple store on Fifth Avenue in New York City.
The Apple store on Fifth Avenue in New York City.
Laurenz Heymann, Unsplash

It seems like the most valuable companies should be those whose products and services we use on a near-daily basis. And according to Forbes’s most recent list, they are: The top five highest-valued brands in the world are Apple, Google, Microsoft, Amazon, and Facebook.

The annual study is based on a complex mixture of metrics that cover revenue and earnings, tax rates, price-to-earnings ratios, and capital employed. Since the data is from 2017 to 2019, the list doesn’t reflect how the coronavirus pandemic has affected the companies in question. That said, it does reflect what many have long assumed: that Big Tech is running laps around all the other industries. The top five are all considered technology companies, as are four others in the top 20 (Samsung, Intel, Cisco, and Oracle). Other companies aren’t in the technology category, but they own lucrative offshoots that are. Disney, in seventh place with an estimated value of $61.3 billion, falls under the “leisure” umbrella—but Disney+ itself would likely be marked “technology.” (Netflix is.)

The list isn’t completely devoid of time-tested classics that don’t involve software or hardware. Coca-Cola edged out Disney by about $3 billion to take sixth place; Toyota placed 11th with a brand value of $41.5 billion; and McDonald’s just cracked the top 10 with $46.1 billion. Louis Vuitton, Nike, and Walmart all also made the top 20.

Just because a brand ranked high on this year’s list doesn’t necessarily mean it’s doing well (and vice versa). Facebook, for example, suffered a 21-percent decrease in brand value compared to Forbes’ 2019 list—the largest loss of all 200 companies included in the study. Netflix’s brand value, on the other hand, jumped a staggering 72 percent from 2019 to 2020. With an estimated $26.7 billion value, it still missed the top 20 by six spots.

See Forbes’s top 20 below, and check out the full list here.

  1. Apple // $241.2 billion
  1. Google // $207.5 billion
  1. Microsoft // $162.9 billion
  1. Amazon // $135.4 billion
  1. Facebook // $70.3 billion
  1. Coca-Cola // $64.4 billion
  1. Disney // $61.3 billion
  1. Samsung // $50.4 billion
  1. Louis Vuitton // $47.2 billion
  1. McDonald’s // $46.1 billion
  1. Toyota // $41.5 billion
  1. Intel // $39.5 billion
  1. Nike // $39.1 billion
  1. AT&T // $37.3 billion
  1. Cisco // $36 billion
  1. Oracle // $35.7 billion
  1. Verizon // $32.3 billion
  1. Visa // $31.8 billion
  1. Walmart // $29.5 billion
  1. GE // $29.5 billion

[h/t Forbes]