Restorative neuromodulation is an innovative therapy designed to treat mechanical low back pain by restoring normal activation of the muscles that stabilise the spine. Unlike traditional neuromodulation therapies that block pain signals, restorative neuromodulation aims to retrain and reactivate the body’s own postural control system.
At PainMed, we offer this evidence-based, non-destructive therapy for patients with chronic back pain due to impaired neuromuscular control, especially when conservative treatments have failed and surgery is not indicated.
Restorative neuromodulation targets the dorsal ramus nerve — which supplies the multifidus muscle, a key stabiliser of the spine. In many people with chronic low back pain, this muscle becomes inhibited or underactive due to injury, prolonged pain, or postural dysfunction.
By stimulating this nerve at regular intervals, the therapy reactivates the multifidus, leading to improved spinal stability and long-term pain reduction.
The treatment uses a small, implanted device that delivers stimulation automatically — no patient programming or sensory feedback is required.
This therapy may be suitable for people with:
It is not intended for nerve root compression, sciatica, or structural instability requiring surgery.
Restorative neuromodulation is typically performed in two stages:
You’ll undergo a thorough clinical assessment, including review of imaging, pain history, physical function, and previous treatments. If multifidus inhibition is suspected, diagnostic testing may be arranged.
The device is implanted during a short surgical procedure under sedation or general anaesthesia. One or two leads are placed in the lumbar spine, and the generator is implanted in a subcutaneous pocket (usually in the flank or lower back).
The system delivers automatic stimulation at regular intervals — no user control or sensory feedback is required.
Unlike conventional neuromodulation that masks pain signals, this therapy aims to:
01
Restore normal movement patterns
02
Rebuild control of spinal stabilisers
03
Enable sustained recovery over time
It’s a functional, rehabilitative approach to chronic back pain — ideal for those whose pain is due to motor control failure, not nerve damage.
Restorative neuromodulation may be appropriate for:
Reports, progress notes, and recommendations are provided to referrers at each stage.
Is Restorative Neuromodulation Right for You?
If you’re living with long-standing back pain that hasn’t responded to therapy or medication — and you’ve been told there’s “nothing else to try” — this may be the next step.
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Originally from England, Sally graduated from St George’s Hospital, University of London in 2004 with a BSc (First Class Hons) in Physiotherapy. Since settling in Australia, Sally has worked in private practice and in the public hospital setting across Sydney.
Sally gained a Masters in Medicine Pain Management from the University of Sydney in 2019 and is a Titled Pain Physiotherapist (as awarded by the Australian Physiotherapy Association).
In addition to private practice, Sally currently works as a Senior Physiotherapist at Westmead Hospital Pain Management Service.
Sally is highly skilled in assessing, diagnosing and treating people who experience chronic pain. She enjoys working with injured workers and CTP claimants. She has a deep understanding of the impact of pain on the whole person and on their functioning in daily life. In partnership with her colleagues, Sally enjoys applying her knowledge and clinical skills to provide a safe space for exploration of the physical and emotional meaning of pain and for recovery of function.
Qualifications and Experience
Dr. Adam is a Fellowship-trained Pain Medicine Specialist with a Fellowship from the Faculty of Pain Medicine (FFPMANZCA) and a Master of Pain Medicine from the University of Sydney. He is dedicated to the comprehensive management of chronic pain across all age groups.
Dr. Adam trained in adult pain medicine at Liverpool Hospital, Nepean Hospital, and the Department of Pain Medicine, and completed additional training in paediatric chronic pain at The Children’s Hospital at Westmead. He currently serves as a Staff Specialist at Westmead and St George Public Hospitals (NSW Health), and is a Visiting Medical Officer (VMO) at Liverpool Public Hospital, St George Private, Sydney Southwest Private, Holroyd Private, Norwest Private, and Nepean Private Hospitals.
He adopts a whole-person, multidisciplinary approach rooted in the socio-psycho-biomedical model, utilising both pharmacologic and interventional techniques. These include:
Dr. Adam is an Authorised Prescriber of Medicinal Cannabis and holds a Diploma in Medicinal Cannabis. He is also certified in Opioid Treatment Programs, including Methadone. His areas of interest include opioid dependence management, medicinal cannabis, and interventional pain procedures.
He also completed advanced training in Virtual Reality Therapy for chronic pain and mental health disorders in Barcelona, Spain, and has further qualifications in Focused Psychological Strategies, Cognitive Behavioural Therapy (CBT), and Clinical Hypnosis.
Qualifications:
