Overview
The Nalu neurostimulation system is one type of nerve stimulator for long-lasting nerve pain. A very small implant is placed under the skin, with a thin wire near the nerve that carries your pain. The implant has no battery inside your body. Instead, it is powered by a small wearable unit that you wear over the implant on the skin. You control the therapy with an app on your smartphone. It may help some people with chronic nerve pain that has not improved with other treatments. You try it first in a short trial, and results vary.
What it is
The Nalu system is made by Nalu Medical. It has three main parts:
- Lead and micro-implant: a thin wire placed near the target nerve, connected to a very small implant under the skin
- Therapy Disc: a wearable unit with a rechargeable battery that powers the implant wirelessly. It is held in place with an adhesive clip or a belt
- Smartphone app: used to turn the therapy on and off and choose settings your care team has set up
The system is FDA-cleared for both peripheral nerve stimulation (PNS) and spinal cord stimulation (SCS) uses. Because there is no implanted battery, no surgery is needed to replace one. The implant is designed for long-term use; the manufacturer's estimate of its expected service life is 18 years.
Who it's for
The Nalu system may help adults with:
- Chronic nerve pain in one area, such as the shoulder, knee, low back, foot or another limb area
- Nerve pain after an injury or surgery
- Pain that has not improved enough with medicines, therapy, injections or other treatments
- People who prefer not to have an implanted battery, and who are comfortable wearing the external unit and using a smartphone app
What the procedure involves, step by step
Step 1: Evaluation. We review your history, exam and imaging. A test nerve block may help show whether a specific nerve carries your pain.
Step 2: The trial. 1. The skin is numbed. Using ultrasound or X-ray guidance, a thin temporary lead is placed near the target nerve through a needle. 2. You wear the trial unit and use the therapy during daily life, usually for several days up to a few weeks. 3. You track your pain and activity. The temporary lead is then removed.
Step 3: The decision. You and your physician review how much your pain and function changed. If the trial did not help enough, nothing more is placed.
Step 4: The implant. 1. If the trial helped, the permanent lead and micro-implant are placed in a minimally invasive outpatient procedure through small incisions, with local numbing and sedation or anesthesia. 2. Most people go home the same day. 3. Your care team sets up the system and shows you how to wear the Therapy Disc and use the app.
Recovery and what to expect
- Soreness at the incisions for a week or two is common.
- You will usually limit certain movements and heavy lifting near the implant area for several weeks while you heal.
- You wear the Therapy Disc when you use the therapy and recharge it as instructed.
- Many people feel a light tingling in the pain area, and some settings are barely felt.
- Some people notice less pain, and some do not. Follow-up visits are used to adjust settings.
Candidacy: who may or may not be a good fit
May be a good fit: adults with chronic nerve pain in a specific area that has not improved with other care, who have a good response during the trial and can manage the wearable unit and app.
May not be a good fit: people with an active infection, a bleeding problem or blood thinners that cannot be safely paused, skin problems that limit wearing the unit, certain other implanted electrical devices, or widespread pain that may be better suited to other options. Ask about MRI rules before any scan.
Risks in brief
Risks include infection, bleeding, skin irritation from the adhesive, lead movement or breakage, discomfort at the implant site, device problems and the need for another procedure. Pain may not improve. We will review your specific risks.
Alternatives
Other options may include medicines, physical therapy, nerve blocks, radiofrequency ablation, temporary 60-day PNS systems, other implanted PNS systems, spinal cord stimulation or dorsal root ganglion stimulation.
Frequently asked questions
Is there a battery inside my body?
No. The Nalu implant is powered wirelessly by a wearable Therapy Disc that you recharge.
Do I have to wear the unit all the time?
You wear the Therapy Disc when you want to use the therapy. Your care team will explain a schedule that fits your plan.
How do I control the therapy?
Through an app on your smartphone, within the settings your care team has set up.
Is there a trial first?
Yes. A short trial lets you see whether the therapy helps before a permanent implant is placed.
How long does the implant last?
It is designed for long-term use. The manufacturer estimates an expected service life of 18 years.
Can the system be removed?
Yes. It can be turned off or removed if needed.
Insurance
GSMC participates with all Aetna plans, including Aetna HMO, and with many other insurance plans. Coverage for a specific procedure depends on your plan and may need prior authorization; call 732-202-3000 to verify. Our team can help check your benefits before treatment.
Book an appointment
One phone number for all 7 GSMC offices in Ocean and Monmouth County.
Our offices
- Whiting
- Toms River (1314 Hooper Ave)
- Brick
- Barnegat
- Manahawkin
- Freehold (322 Professional View Dr)
- West Long Branch
Telehealth visits are available for second opinions and imaging reviews only, by phone. Please call 732-202-3000 to book one.
This page is general patient education and does not replace advice from your own clinician. Individual results vary, and no outcome can be promised.