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Review of the Quell Wearable Pain Relief Device
Being “drug-free” usually references illegal substance abuse, but prescriptions for chronic pain can lead to damaging dependency as well. For those eager to try a pain reliever that doesn’t require popping pills, wearable technology and neuroscience may have an answer.
NeuroMetrix claims to have found a workable solution that could apply to anyone dealing with chronic pain from illness, injuries or disability. The Quell ($249 on Amazon) is a device that you wear on your calf, but treats pain anywhere—your back, shoulder, knee—using electro-stimulation to provide relief through the body’s own internal painkillers.
On its base premise alone, you could be forgiven for viewing this as pie in the sky out of an infomercial, but there is evidence to back it up, and the Food and Drug Administration (FDA) has approved it through the 510(k) process as a Class II Medical Device for chronic pain relief. Where it’s placed also makes it easy to discount Quell’s ability to provide relief. But that too is based in science.
The upper calf holds a number of different nerve endings that traverse the body. The technology in the Quell makes it a Transcutaneous Electrical Nerve Stimulation (TENS) unit because it essentially sends pulses through that area and up the spinal cord, triggering the brain to raise endorphins. This prevents or reduces pain signals from reaching the brain, while releasing opioids to relieve pain in the process.
Opioids are the key here. Medical research going back to the 1960s experimented with high frequency peripheral nerve stimulation to gauge how they can respond and elevate natural pain modulating chemicals in the cerebrospinal fluid (CSF). Without getting into too much medical terminology, hydrocodone, meperidine and oxycodone are prescription opioids that can do the same thing, except they do so through a different receptor in the body than electro-stimulation does. The results may be similar, but the path to get there isn’t necessarily the same, according to a whitepaper written by Dr. Shai Gozani, founder and CEO at NeuroMetrix.
In other words, the pills could have side-effects, while the Quell shouldn’t.
As opioid levels increase, they stick around for about 40 minutes after the stimulation ceases. This is why the Quell stimulates for one hour, and then automatically turns off on its own for another hour, before turning back on again. The on-off process allows the opioids to keep working until they go back to baseline levels, avoiding overstimulation.
While there are other over-the-counter TENS units available, like the Icy Hot line, none of the others are designed for chronic pain and all-day wear, including while sleeping. And, none of the others qualify for insurance reimbursement.
Getting set up and started is a breeze. The flexible sports band includes a holster for the device, which also has an open slit on either side — one for the power button, the other revealing two clips. The latter are meant to attach to a strip of gels that adhere to the skin, holding it all in place, while also pushing through the electric pulses the device generates.
The strap has to be worn on the upper calf (left or right, doesn’t matter), and go through a quick calibration process consisting of holding the power button for five seconds each time to increase pulse strength to a comfortable level of tolerance that doesn’t feel like being shocked. You should feel it work, though feel relaxed at the same time.
It’s designed to be worn anytime you need the relief, which can vary from all times of the day to instances where pain may be more prominent. This also includes during sleep, and the device has been optimized to recognize the wearer is in a slumber when the user sets it manually on the free Quell iOS or Android app, or reduces pulse strength to a gentler mode that isn’t distracting by pressing the button on the side. Wearing it during sleep is somewhat of a novelty, considering NeuroMetrix is currently the only company to have a TENS device available over the counter that is cleared for use while asleep.
Neither waterproof nor especially sweatproof, there’s something of a fine line when and where the Quell can be used during activity. Marketing materials and images show a runner and golfer, and those two activities probably could work, given that the device can excel in more passive sports and activities — of which there are many. Golf, table tennis, rollerblading, hiking, brisk walking, bike riding, billiards and driving, among others.
Even in the gym, the bike, elliptical, treadmill and other machines should be fine. It is possible to wear the Quell during a gym workout, but I personally found it to be distracting. For example, leg exercises can feel a little off if the Quell is pulsing at the same time. Upper body exercises are generally fine, though I personally opted not to wear it during heavy cardio activity.
Activities that probably wouldn’t work, either because of equipment or environment, would be ice hockey, beach volleyball, football or almost any other sport where diving, water or physical contact is going to happen. The device doesn’t have any serious protection and isn’t ruggedized to withstand punishment.
Note that people with a cardiac pacemaker, implanted defibrillator or other implanted metallic or electronic device are best served to consult with their doctor first before using the device
Does Quell work?
I’ve battled tendinitis in both knees in the past, and have a hip flexor issue that sometimes leads to pain and discomfort. Both problems made me a good candidate to discover what kind of pain relief could be achieved from this device.
In my case, I’ve worn the device since January. It took three days before I started feeling a positive effect, yet took weeks before a lasting impact left an impression on me. NeuroMetrix recommends four-to-six hours “for the first several weeks,” which I would agree with. I wore it all the time, regardless of whether I was home or out at a social gathering. I even traveled with it. Under a pair of jeans or pants, the device was pretty inconspicuous.
The Quell soon faded into the background, to the point where I neither noticed the pulses nor the pain unless I strained or twisted my body too much. It never woke me up from sleep and the gel strips held up well, though I never used them during rigorous workouts.
The company says that some users may experience skin irritation. Other than a little itchiness at the start, I experienced nothing like that.
One thing that’s difficult to assess when testing a product like Quell is how it might impact someone else. A review on Forbes from someone with myofascial pain syndrome found it lessened her pain. Know that the device is inherently subjective because the wearer’s body reacts to it at different intensities. By no means, is it a cure for chronic pain, only a medication-free substitute that can do away with prescriptions to painkillers.
That being said, the Quell isn’t going to do anything for chronic headaches and migraines because they occur in a different area of the brain. Debilitating injuries that are really severe, like fractures, cracked ribs or torn tendons may not benefit from the Quell’s pulses, but you should consult a doctor before using the device, in any case.
This is why NeuroMetrix seems to try not promising too much, noting that the Quell is well-suited for those suffering from sciatica pain, fibromyalgia, diabetic neuropathy and osteoarthritis. All of those are chronic musculoskeletal conditions that require regular maintenance, which is what the device is designed for. Standard and temporary aches and pains from tough games or workouts can be lessened with it, but that’s not the main purpose.
Battery life is rated at about 30-40 hours, which is mostly accurate, as the number is affected by how intense the pulses are. I easily went a full 36 hours using it before needing to recharge the unit (which takes about two hours to recharge), but found that I had to take it off every few hours or so to let my skin breathe in my upper calf.
The Quell app
The free Quell app isn’t required to operate the device, but exists as a way to learn how to use the device and track progress over a current therapy session or over the course of a day. Manual controls are limited, except it is possible to set the device to Full Power, Bedtime Only or Gentle Overnight. Bedtime Only limits therapy only to when falling asleep. The setting only applies, however, to when the device itself is on Auto-Restart (which it is by default), meaning that a new 60-minute cycle begins every second hour.
Beyond that, you can use the app to note when you replaced the electrode strips, and then get a notification on your phone that they are due for replacement later on. The app is helpful for troubleshooting Bluetooth pairing issues and offers a direct link to purchase new strips from the company website.
Paying for Quell
At $250 to start (it comes with two strips in the box), the Quell isn’t inexpensive, yet isn’t priced out of reach, either. Despite clearance from the FDA to sell the Quell without a prescription, the company concedes most insurance companies will not cover the cost directly. Instead, it encourages prospective buyers to contact their insurer to find out for sure. For those enrolled in either the Flexible Spending Account (FSA) or Health Savings Account (HSA) programs, the device is entirely eligible for reimbursement. There is a 60-day money back guarantee in case you come away feeling like it did nothing for you.
The gel strips are where NeuroMetrix ultimately derives its earnings. At $30 for a pair (or $29.95 on Amazon), each of which last two weeks upon daily usage, the Quell effectively becomes a monthly expense for the regular wearer. Readily available through the company website or Amazon, users can save a little money buying larger packs that include more strips at a reduced price.
It’s the residual cost that has to be measured because, assuming that it’s to be worn daily, that’s another $30 per month. If prescriptions are costing more than that, there may be a savings to consider here, both in monetary and health terms.
The bottom line
Wearable technology may still be unproven, in many respects, but the Quell bucked the trend, showing me that it was anything but snake oil. It shouldn’t be misconstrued as a replacement for physiotherapy and other treatments that can reverse chronic pain or injury, but when it comes to management, this is one device that can make a difference.
While skeptical at first, I’ve since come away feeling like it worked for me. I know not to shirk my exercise and rehab routine, but at least the Quell helps in between when I could use some relief. It is worth a try if you find yourself in the same position.
Quell Wearable Pain Relief Device
[Image credits: Ted Kritsonis/Techlicious, Quell]