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Neuromodulation includes therapies that alter nerve activity by delivering electrical or pharmaceutical agents directly to a target area. Neurostimulation is the modulation of the nervous system with electrical signals and is used as a treatment for unmanageable chronic pain and/or movement disorders.

Different forms of neuromodulation exist: 

• Spinal Cord Stimulation (SCS) where the nervous tissues on a specific portion of the spinal cord are electrically stimulated to block pain signals to the brain.  SCS is generally indicated for use as an aid in the management of chronic, intractable pain of the trunk and/or limbs; stable intractable Angina Pectoris or Peripheral Vascular Disease in patients who are not candidates for revascularization.
• Peripheral Nerve Stimulation (PNS) where a specific nerve or an area of pain is targeted to relieve pain locally. PNS is generally indicated for use as an aid in the management of chronic intractable pain of the trunk and/or limbs or implanted subcutaneously for chronic intractable pain of the posterior trunk.  
• Deep Brain Stimulation (DBS) is a highly targeted, mild electrical stimulation in the brain which influences movement control, specifically on either the subthalamic nucleus, the internal globus pallidus or the ventral intermediate nucleus of the thalamus. DBS could be indicated in the treatment of Movement Disorders (Parkinson's disease, Essential Tremor, Dystonia), Obsessive-Compulsive Disorders and Epilepsy.
• Sacral Neuromodulation (SNM) involves the stimulation of the sacral nerves to modulate the neural reflexes that influence the lower urinary and intestinal tracts. SNM is generally indicated for the management of overactive bladder, Non-obstructive urinary retention and fecal incontinence. 
• Intrathecal Drug Delivery (IDD) consists of the delivery of a pharmacology agent directly to the target site, around the spinal cord (in the intrathecal space). IDD can be used to treat chronic pain (by administrating opioid and non-opioid analgesics) or spasticity (by infusing baclofen) which is then called ITB (Intrathecal Baclofen). IDD is recommended by the PACC for some of the following painful conditions: Failed Back Surgery Syndrome, Complex Regional Pain Syndrome, back, abdominal/pelvic, trunk, extremities pain and cancer pain or when analgesic efficacy with systemic opioids is complicated by intolerable side effects.

Different manufacturers of neuromodulation systems may have different approved indications for use. Always refer to the product manufacturers labelling. 

ECMT is aware that the constant expansion of the use of Interventional Neuromodulation therapies as a standard of care for patients suffering from these disorders, poses a new educational challenge and has therefore committed itself to support the transfer of knowledge and experience which is essential to meet the quality standards required by these therapies.