ReActiv8: Neurostimulation for Chronic Mechanical Low Back Pain
ReActiv8 is an implantable neurostimulation system designed for a specific and very common form of chronic low back pain — chronic mechanical low back pain driven by multifidus muscle dysfunction.
The Problem: The Failing Multifidus
The multifidus is a deep spinal muscle that runs along the entire lumbar spine. It is the primary stabilizer of the lumbar vertebrae, activating with every movement to protect the spine from injury. In patients with chronic low back pain, the multifidus becomes neurologically inhibited — it stops working properly. This leads to spinal instability, abnormal loading patterns, and ongoing pain.
The critical insight behind ReActiv8 is that this multifidus dysfunction is neurological, not structural — and it can be reversed with the right electrical stimulation.
How ReActiv8 Works
Two small leads are implanted near the L2 medial branch nerves — the nerves that control the multifidus. A small implantable pulse generator (IPG) delivers electrical stimulation twice daily for 30-minute sessions, causing the multifidus to contract rhythmically. Over time, this re-trains the muscle and restores its function.
Unlike spinal cord stimulation — which masks pain signals — ReActiv8 addresses an underlying driver of the pain itself. Patients use a handheld controller to initiate their twice-daily stimulation sessions.
The implantation is an outpatient procedure performed under sedation. It is fully reversible.
Who Is a Candidate?
ReActiv8 is appropriate for patients with:
- Chronic mechanical low back pain lasting 6+ months
- Predominant axial low back pain (pain in the back itself, not primarily radiating into the leg)
- Failed conservative treatment including physical therapy and injections
- No evidence of significant structural pathology requiring surgery
Clinical Evidence
The RESTORE trial — a randomized controlled study — demonstrated significant and durable pain reduction and functional improvement in patients treated with ReActiv8, with results maintained at long-term follow-up.
Frequently Asked Questions
How often do I use the device? Twice daily for 30 minutes each session. The stimulation is perceptible — you will feel your back muscles contracting. Most patients find the sensation comfortable and manageable.
Is this reversible? Yes. The system can be deactivated or surgically removed if needed.
Is it covered by insurance? Coverage is evolving. Our office will verify your specific benefits prior to scheduling.
Contact Us
Call 516-492-3100 to find out if ReActiv8 may be right for your chronic low back pain.