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The vocabulary, defined plainly
Neuromodulation carries an unusual density of jargon — some anatomical, some clinical, much of it invented by manufacturers. Every term used anywhere on this site is defined here, in language that assumes no medical training.
53 terms
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- 10 kHz therapy Technology
- Nevro's high-frequency waveform delivered at 10,000 Hz — far above the frequency at which paresthesia can be perceived, so lead placement is guided by anatomy rather than by patient feedback.
A
- Allodynia Clinical
- Pain caused by something that should not be painful at all — light touch, the weight of a bedsheet, a breeze. A hallmark of a sensitized nervous system.
- Amplitude Technology
- The strength of each stimulation pulse, measured in milliamps or volts. Raising it recruits more nerve fibres; raising it too far makes stimulation uncomfortable.
B
- Burst stimulation Technology
- A waveform delivering closely grouped clusters of pulses separated by quiet periods, rather than an even train. Designed to work below the threshold of sensation.
BurstDR (Abbott)
C
- Cauda equina Anatomy
- The bundle of nerve roots continuing down the spinal canal below roughly the L1–L2 level, where the spinal cord itself ends in most adults.
- Central sensitization Clinical
- A state in which the spinal cord and brain become more responsive to incoming signals, so pain is amplified and spreads beyond the original area. A key reason chronic pain persists after tissue has healed.
- Closed-loop stimulation Technology
- A system that measures the spinal cord's electrical response to each pulse and automatically adjusts the next one to keep neural activation on target, rather than delivering a fixed output.
- CRPS Clinical
- Complex regional pain syndrome — a chronic, often severe pain condition usually affecting a limb, frequently after injury or surgery, with disproportionate pain plus changes in skin, temperature and swelling. A classic indication for DRG stimulation.
- CSF Anatomy
- Cerebrospinal fluid — the fluid surrounding the spinal cord within the dura. Its varying thickness between the lead and the cord is the reason stimulation intensity can change with body position.
D
- Dermatome Anatomy
- The area of skin supplied by a single spinal nerve root. Dermatomal maps are why a compressed nerve root produces pain in a predictable pattern.
- Dorsal columns Anatomy
- The large sensory fibre tracts on the posterior surface of the spinal cord. Their proximity to a posteriorly placed epidural lead is what makes spinal cord stimulation possible.
- Dorsal horn Anatomy
- The posterior region of the spinal cord's grey matter, where incoming pain signals are processed, amplified or dampened before travelling on toward the brain.
- DRG Anatomy
- Dorsal root ganglion — a small cluster of sensory nerve cell bodies sitting in the intervertebral foramen, just outside the spinal cord. Each one maps to a defined body region.
- DTM Technology
- Differential Target Multiplexed stimulation — Medtronic's waveform delivering multiple interleaved programs, developed from work suggesting stimulation can influence glial cells as well as neurons.
E
- ECAP Technology
- Evoked compound action potential — the electrical signal the spinal cord produces in response to a stimulation pulse. It is an objective measure of how much neural tissue was activated, and it is the feedback signal used by closed-loop systems.
- Embrace One Technology
- BIOTRONIK Neuro's patient support programme for the Prospera system. A dedicated care team reviews automatically transmitted therapy data seven days a week, alongside the implanting practice. It is a support and management service, not a diagnostic or emergency one.
- Epidural space Anatomy
- The space inside the bony spinal canal but outside the dura. This is where spinal cord stimulator leads are placed, and the same space used for epidural injections.
HomeStream (BIOTRONIK)
F
- FAST Technology
- Fast-Acting Sub-perception Therapy — Boston Scientific's paresthesia-free waveform, intended to produce relief quickly rather than over a long titration period.
- Fluoroscopy Procedure
- Live X-ray imaging used during lead placement, allowing the physician to watch the needle and lead in real time and confirm position in multiple views.
- Foramen Anatomy
- The bony opening between adjacent vertebrae through which a nerve root exits the spine. The dorsal root ganglion sits within it.
Intervertebral foramen
H
- HFX Technology
- Nevro's therapy programme built around 10 kHz high-frequency spinal cord stimulation, including the HFX iQ algorithm-guided programming platform.
- Hyperalgesia Clinical
- An exaggerated pain response to something that would normally be only mildly painful. Like allodynia, a marker of sensitized signaling.
I
- IPG Technology
- Implantable pulse generator — the device that produces the stimulation, implanted under the skin. It may be rechargeable, recharge-free, or in some systems contain no battery at all.
L
- Laminotomy Procedure
- A small surgical opening made in the bony lamina at the back of a vertebra, required to place a flat paddle lead into the epidural space.
- Lead Technology
- The thin insulated wire carrying electrode contacts that delivers stimulation. Percutaneous leads are cylindrical and placed through a needle; paddle leads are flat and require a laminotomy.
- Lead migration Clinical
- Movement of a lead from its programmed position, changing or losing coverage. The most common complication of spinal cord stimulation, and the reason activity restrictions matter during healing.
M
- MRI conditional Technology
- A device labeled as safe for MRI scanning only under specific conditions — field strength, coil type, scan region and settings. Conditions differ substantially between systems.
- Multifidus Anatomy
- A deep stabilising muscle running along the spine. Impaired control of the lumbar multifidus is the specific target of restorative neurostimulation with ReActiv8.
- Multiphase stimulation Technology
- BIOTRONIK's RESONANCE approach, distributing charge across the electrode array in both space and time to activate the dorsal horn at lower power than conventional stimulation.
N
- Neuromodulation Therapy
- The umbrella term for therapies that alter nerve activity by delivering targeted electrical or chemical stimulation, rather than by cutting, removing or destroying tissue.
- Neuropathic pain Clinical
- Pain caused by damage or disease affecting the nerves themselves, typically described as burning, electric, shooting or numb-but-painful. Historically the pain type most responsive to neuromodulation.
- Nociceptive pain Clinical
- Pain from actual or threatened tissue damage, reported accurately by an intact nervous system — an arthritic joint, a torn muscle, a fracture.
- Nociplastic pain Clinical
- Pain arising from altered nervous system processing rather than clear tissue or nerve damage. The category most closely tied to central sensitization.
- Non-surgical refractory back pain Clinical
- Chronic back pain in patients who have not had spine surgery and are not candidates for it. Several stimulation platforms now hold specific FDA indications for this population.
NSRBP
O
- ODI Clinical
- Oswestry Disability Index — a validated questionnaire measuring how much back pain limits daily activity. Frequently used alongside pain scores as a functional outcome measure.
- Open-loop stimulation Technology
- A system that delivers exactly what it was programmed to deliver, with no measurement of the resulting neural response. How most stimulators work.
P
- Paddle lead Technology
- A flat lead, insulated on one side so energy is directed toward the spinal cord. Requires a small laminotomy to place, but migrates less than a percutaneous lead.
- Paresthesia Clinical
- The tingling, buzzing or vibrating sensation produced when stimulation activates sensory fibres above the perception threshold. Essential to traditional tonic stimulation; deliberately avoided by most modern waveforms.
- PDN Clinical
- Painful diabetic neuropathy — nerve pain in the extremities caused by diabetes, now a labeled indication for several spinal cord stimulation systems.
- Percutaneous lead Technology
- A cylindrical lead placed through a needle without an open incision. The most common lead type for both trials and permanent implants.
- Persistent spinal pain syndrome Clinical
- The preferred modern term for chronic pain continuing after spine surgery — replacing 'failed back surgery syndrome', which misattributes the problem to a failure of the operation or the patient.
- PNS Therapy
- Peripheral nerve stimulation — stimulation delivered at a specific named peripheral nerve rather than at the spinal cord. Available as a permanent implant or as a temporary 60-day therapy.
- Proactive care Technology
- A follow-up model in which the implanted system reports its own data to the care team automatically, so a problem can be found before the patient notices it — rather than waiting for the next scheduled visit. BIOTRONIK's HomeStream and Embrace One are the clearest current example.
- Pulse width Technology
- How long each individual stimulation pulse lasts, measured in microseconds. Influences which nerve fibres are preferentially activated.
Formerly FBSS
R
- Radiculopathy Clinical
- Pain, numbness or weakness caused by irritation or compression of a spinal nerve root, typically radiating along that root's dermatome into an arm or leg.
- Recharge-free IPG Technology
- A generator with a primary-cell battery that the patient never charges. It is replaced surgically when depleted, typically after several years.
- Rechargeable IPG Technology
- A generator whose battery is recharged through the skin by the patient. Charging frequency varies enormously by platform and settings — from a handful of times a year to weekly or more.
- Responder Clinical
- The conventional benchmark in neuromodulation studies: a patient achieving at least 50% reduction in pain. Useful for comparison, but a narrow definition of a good outcome.
- Restorative neurostimulation Therapy
- A therapy designed to activate the lumbar multifidus and facilitate recovery of neuromuscular control. ReActiv8's intended primary mechanism is motor activation rather than dorsal-column stimulation, making it distinct from SCS.
Primary cell
S
- SCS Therapy
- Spinal cord stimulation — delivery of controlled electrical energy from leads in the epidural space to modulate pain signal processing in the spinal cord.
- Sub-perception stimulation Technology
- Stimulation delivered below the threshold at which you can feel it, so therapy is provided without paresthesia. The design goal of most modern waveforms.
Paresthesia-free
T
- Tonic stimulation Technology
- The original spinal cord stimulation waveform: a steady train of pulses, typically 40–100 Hz, delivered above the perception threshold to produce paresthesia over the painful area.
- Trial period Procedure
- The roughly week-long test of the therapy using temporary leads that exit through the skin and are removed in the office afterwards. No permanent implant occurs until the trial demonstrates benefit.
Keep learning, then bring your questions to a clinician
Understanding the terms is a start. Your own clinician can put them in the context of your history and imaging.