Treatment of indications using electrical stimulation

Abstract

In one embodiment, a method includes implanting an implant entirely under the subject's skin. The implant includes a passive electrical conductor of sufficient length to extend from subcutaneous tissue located below one of a surface cathodic electrode and a surface anodic electrode to the tibial nerve. The surface electrodes are positioned in spaced relationship on the subject's skin, with one of the electrodes positioned over the pick-up end of the electrical conductor such that the portion of the current is transmitted through the conductor to the tibial nerve, and such that the current flows through the tibial nerve and returns to the other of the surface cathodic electrode and the surface anodic electrode. An electrical current is applied between the surface cathodic electrode and the surface anodic electrode to cause the portion of the electrical current to flow through the implant to stimulate the tibial nerve.

1 . A method for electrically stimulating a tibial nerve to treat incontinence in a subject, comprising:
 implanting an implant entirely under the subject's skin, the implant being configured to act as a conductive pathway for at least a portion of an electrical current flowing between a surface cathodic electrode and a surface anodic electrode to be positioned in spaced relationship on the subject's skin and to transmit the portion of the electrical current to the tibial nerve;   the implant comprising a passive electrical conductor of sufficient length to extend, once implanted, from subcutaneous tissue located below one of the surface cathodic electrode and the surface anodic electrode to the tibial nerve, the electrical conductor having a pick-up end and a stimulating end and being insulated between the pick-up end and the stimulating end, the pick-up end being positioned in subcutaneous tissue located below the one of the surface cathodic electrode and the surface anodic electrode and forming an electrical termination having a sufficient surface area to allow a portion of the electrical current to flow through the conductor to the stimulating end, the stimulating end being positioned proximate to the tibial nerve and forming an electrical termination to deliver the portion of electrical current to the tibial nerve to stimulate the tibial nerve;   positioning the surface cathodic electrode and the surface anodic electrode in spaced relationship on the subject's skin, with one of the surface cathodic electrode and the surface anodic electrode positioned over the pick-up end of the electrical conductor such that the portion of the current is transmitted through the conductor to the tibial nerve, and such that the current flows through the tibial nerve and returns to the other of the surface cathodic electrode and the surface anodic electrode; and   applying an electrical current between the surface cathodic electrode and the surface anodic electrode to cause the portion of the electrical current to flow through the implant to stimulate the tibial nerve.   
     
     
         2 . The method of  claim 1 , wherein during the applying, after the electric current is transmitted to the tibial nerve, at least a portion of the electric current is transmitted through body tissues extending between the tibial nerve and subcutaneous tissue located below the other of the surface cathodic electrode and the surface anodic electrode. 
     
     
         3 . The method of  claim 1 , wherein during the applying, after the electric current is transmitted to the tibial nerve, at least a portion of the electric current is transmitted through an implanted electrical return conductor extending between the tibial nerve and subcutaneous tissue located below the other of the surface cathodic electrode and the surface anodic electrode. 
     
     
         4 . The method of  claim 1 , wherein the applying includes, applying at least one of direct, pulsatile or alternating electrical current between the surface cathodic electrode and the surface anodic electrode. 
     
     
         5 . An apparatus for electrically stimulating a tibial nerve to treat incontinence in a subject, comprising:
 an implant configured to be disposed entirely under the subject's skin, the implant configured to act as a conductive pathway for at least a portion of an electrical current flowing between a surface cathodic electrode and a surface anodic electrode to be positioned in spaced relationship on the subject's skin and to transmit the portion of the electrical current to the tibial nerve,   the implant including a passive electrical conductor, a pick-up end and a stimulating end,
 the passive electrical conductor being insulated between the pick-up end and the stimulating end and having a sufficient length to extend, once implanted, from subcutaneous tissue located below one of the surface cathodic electrode and the surface anodic electrode to the tibial nerve, 
 the pick-up end configured to be positioned in subcutaneous tissue located below the one of the surface cathodic electrode and the surface anodic electrode and forming an electrical termination having a sufficient surface area to allow a portion of the electrical current to flow through the conductor to the stimulating end, and 
 the stimulating end being positioned proximate to the tibial nerve and forming an electrical termination to deliver the portion of electrical current to the tibial nerve to stimulate the tibial nerve. 
   
     
     
         6 . The apparatus of  claim 5  wherein the pick-up end of the implant is configured to be positioned in subcutaneous tissue below the surface cathodic electrode. 
     
     
         7 . The apparatus of  claim 5  wherein the pick-up end of the implant is configured to be positioned in subcutaneous tissue below the surface anodic electrode. 
     
     
         8 . The apparatus of  claim 5  wherein the pick-up end includes an electrode. 
     
     
         9 . The apparatus of  claim 5  wherein the stimulating end includes an electrode. 
     
     
         10 . A method for electrically stimulating a wound in a subject, comprising:
 implanting an implant entirely under the subject's skin, the implant being configured to act as a conductive pathway for at least a portion of an electrical current flowing between a surface cathodic electrode and a surface anodic electrode to be positioned in spaced relationship on the subject's skin and to transmit the portion of the electrical current to the wound;   the implant comprising a passive electrical conductor of sufficient length to extend, once implanted, from subcutaneous tissue located below one of the surface cathodic electrode and the surface anodic electrode to a location proximate the wound, the electrical conductor having a pick-up end and a stimulating end and being insulated between the pick-up end and the stimulating end, the pick-up end being positioned in subcutaneous tissue located below the one of the surface cathodic electrode and the surface anodic electrode and forming an electrical termination having a sufficient surface area to allow a portion of the electrical current to flow through the conductor to the stimulating end, the stimulating end being positioned proximate to the wound and forming an electrical termination to deliver the portion of electrical current to the wound to stimulate wound healing;   positioning the surface cathodic electrode and the surface anodic electrode in spaced relationship on the subject's skin, with one of the surface cathodic electrode and the surface anodic electrode positioned over the pick-up end of the electrical conductor such that the portion of the current is transmitted through the conductor to the wound, and such that the current flows through the wound and returns to the other of the surface cathodic electrode and the surface anodic electrode; and   applying an electrical current between the surface cathodic electrode and the surface anodic electrode to cause the portion of the electrical current to flow through the implant to stimulate wound healing.   
     
     
         11 . The method of  claim 10 , wherein during the applying, after the electric current is transmitted to the wound, at least a portion of the electric current is transmitted through body tissues extending between the wound and subcutaneous tissue located below the other of the surface cathodic electrode and the surface anodic electrode. 
     
     
         12 . The method of  claim 10 , wherein during the applying, after the electric current is transmitted to the wound, at least a portion of the electric current is transmitted through an implanted electrical return conductor extending between the wound and subcutaneous tissue located below the other of the surface cathodic electrode and the surface anodic electrode. 
     
     
         13 . The method of  claim 10 , wherein the applying includes, applying at least one of direct, pulsatile or alternating electrical current between the surface cathodic electrode and the surface anodic electrode. 
     
     
         14 . The method of  claim 10 , wherein the wound is on a surface of the patient's skin. 
     
     
         15 . The method of  claim 10 , wherein the wound is disposed below the subcutaneous tissue of the patient. 
     
     
         16 . A method for electrically stimulating a tissue in proximity to a joint in a subject, comprising:
 implanting an implant entirely under the subject's skin, the implant being configured to act as a conductive pathway for at least a portion of an electrical current flowing between a surface cathodic electrode and a surface anodic electrode to be positioned in spaced relationship on the subject's skin and to transmit the portion of the electrical current to a tissue in proximity to a joint;   the implant comprising a passive electrical conductor of sufficient length to extend, once implanted, from subcutaneous tissue located below one of the surface cathodic electrode and the surface anodic electrode to a location proximate the joint, the electrical conductor having a pick-up end and a stimulating end and being insulated between the pick-up end and the stimulating end, the pick-up end being positioned in subcutaneous tissue located below the one of the surface cathodic electrode and the surface anodic electrode and forming an electrical termination having a sufficient surface area to allow a portion of the electrical current to flow through the conductor to the stimulating end, the stimulating end being positioned proximate to the joint and forming an electrical termination to deliver the portion of electrical current to the tissue in proximity to the joint to stimulate the joint;   positioning the surface cathodic electrode and the surface anodic electrode in spaced relationship on the subject's skin, with one of the surface cathodic electrode and the surface anodic electrode positioned over the pick-up end of the electrical conductor such that the portion of the current is transmitted through the conductor to the tissue in proximity to the joint, and such that the current flows through the tissue and returns to the other of the surface cathodic electrode and the surface anodic electrode; and   applying an electrical current between the surface cathodic electrode and the surface anodic electrode to cause the portion of the electrical current to flow through the implant to stimulate the joint.   
     
     
         17 . The method of  claim 16 , wherein during the applying, after the electric current is transmitted to the tissue in proximity to the joint, at least a portion of the electric current is transmitted through body tissues extending between the joint and subcutaneous tissue located below the other of the surface cathodic electrode and the surface anodic electrode. 
     
     
         18 . The method of  claim 16 , wherein during the applying, after the electric current is transmitted to the tissue in proximity to the joint, at least a portion of the electric current is transmitted through an implanted electrical return conductor extending between the joint and subcutaneous tissue located below the other of the surface cathodic electrode and the surface anodic electrode. 
     
     
         19 . The method of  claim 16 , wherein the applying includes, applying at least one of direct, pulsatile or alternating electrical current between the surface cathodic electrode and the surface anodic electrode. 
     
     
         20 . The method of  claim 16 , wherein the joint is one of a knee joint and a hip joint. 
     
     
         21 . A method for electrically stimulating a common peroneal nerve in a patient, comprising:
 disposing a first end of an implant under a patient's skin at a first location in proximity to a common peroneal nerve of the patient;   disposing a second end of the implant under the patient's skin at a second location at a non-zero distance from the first end of the implant, the implant including a passive electrical conductor extending under the patient's skin between the first end and the second end;   placing a cathodic electrode on an exterior surface of the patient's skin at a first location;   placing an anodic electrode on an exterior surface of the patient's skin in spaced relationship to the cathodic electrode; and   delivering an electrical current to one of the cathodic electrode and the anodic electrode such that a portion of the electric current is transmitted through the second end of the implant, through the conductor to the first end of the implant and into the common peroneal nerve to stimulate the common peroneal nerve.   
     
     
         22 . The method of  claim 21 , wherein during the applying, after the electric current is transmitted to the common peroneal nerve, at least a portion of the electric current is transmitted through body tissues extending between the joint and subcutaneous tissue located below the other of the surface cathodic electrode and the surface anodic electrode. 
     
     
         23 . The method of  claim 21 , wherein during the applying, after the electric current is transmitted to the joint, at least a portion of the electric current is transmitted through an implanted electrical return conductor extending between the common peroneal nerve and subcutaneous tissue located below the other of the surface cathodic electrode and the surface anodic electrode. 
     
     
         24 . The method of  claim 21 , wherein the applying includes, applying at least one of direct, pulsatile or alternating electrical current between the surface cathodic electrode and the surface anodic electrode. 
     
     
         25 . A method for electrically stimulating a muscle in a patient, comprising:
 disposing a first end of an implant under a patient's skin at a first location in proximity to at least one of a muscle or a nerve innervating the muscle of the patient;   disposing a second end of the implant under the patient's skin at a second location at a non-zero distance from the first end of the implant, the implant including a passive electrical conductor extending under the patient's skin between the first end and the second end;   placing a cathodic electrode on an exterior surface of the patient's skin at a first location;   placing an anodic electrode on an exterior surface of the patient's skin in spaced relationship to the cathodic electrode; and   delivering an electrical current to one of the cathodic electrode and the anodic electrode such that a portion of the electric current is transmitted through the second end of the implant, through the conductor to the first end of the implant and into the one of the muscle or the nerve innervating the muscle to stimulate rehabilitation of the muscle.   
     
     
         26 . The method of  claim 25 , further comprising:
 attaching a vibration sensor capable of detecting mechanical vibrations to patient; and   detecting with the sensor, mechanical vibrations elicited by sudden contact of the patient's upper teeth and lower teeth, the delivering being actuated based on the detecting.   
     
     
         27 . A method for electrically stimulating a fracture or break in a bone of a patient to promote bone growth, comprising:
 disposing a first end of an implant under a patient's skin at a first location in proximity to a targeted bone defect of the patient;   disposing a second end of the implant under the patient's skin at a second location at a non-zero distance from the first end of the implant, the implant including a passive electrical conductor extending under the patient's skin between the first end and the second end;   placing a cathodic electrode on an exterior surface of the patient's skin at a first location;   placing an anodic electrode on an exterior surface of the patient's skin in spaced relationship to the cathodic electrode; and   delivering an electrical current to one of the cathodic electrode and the anodic electrode such that a portion of the electric current is transmitted through the second end of the implant, through the conductor to the first end of the implant and into the targeted bone defect to promote bone growth.   
     
     
         28 . The method of  claim 27 , further comprising:
 positioning an orthosis on an exterior portion of the patient and adjacent the second end of the implant, wherein the delivering includes delivering electrical current from the orthosis to the cathodic electrode.