Learn more about the following:

Pain

What is pain?
The International Association for the Study of Pain (IASP) defines pain as “an unpleasant sensory and emotional experience associated with, or resembling that associated with actual or potential tissue damage”*. Pain is an uncomfortable feeling or sensation that tells us something may be wrong in a part of our bodies. It comes in different forms – sharp jabs, dull aches, throbbing, burning and so on.
 
It’s important to understand that pain is not generated by the body tissues – it’s a messaging system that involves lots of elements, including nerves, immune cells and chemicals. These elements are combined and processed in our brain to create pain messages that are influenced by our memory, emotion and attention, in a way that is unique to each person. These messages are designed to change our behaviour, in order to protect us from harm.
 
* IASP. The International Association for the Study of Pain (IASP) 2024 [Available from: https://www.iasp-pain.org/resources/terminology/].
How do painkillers work?
Pain relief drugs mostly work by binding to certain receptors in the brain and spinal cord. These drugs moderate the signals being interpreted by the brain, thereby increasing our tolerance for pain. Other drugs are anti-inflammatory, reducing the swelling in the damaged tissue, which in turn helps moderate the signals being sent from the nerve fibres to the brain*.
 
* Alorfi NM. Pharmacological methods of pain management: Narrative review of medication used. International Journal of General Medicine. 2023:3247-56.
What is chronic pain?
Chronic pain is pain that lasts longer than three months. It is also called persistent pain or long-term pain. It is often described as “pain that does not go away after the expected recovery time following an injury or illness”. The underlying tissue damage from most injuries tends to heal within about three months.
 
Chronic pain is thought to occur when nerves become over-sensitive and over-stimulated, and send warning messages to the brain predicting pain, even when there is no injury, or the original injury causing the pain has healed*. The brain keeps reacting to these signals, predicting future pain and generating pain sensations, a bit like a broken record.
 
Another way of looking at it is thinking about pain as a ‘fire alarm’ in your body. With chronic pain, the alarm keeps ringing, even though the ‘fire’ (the underlying tissue damage) has been put out.
 
Eventually, our brains get stuck in a rut, needing fewer and fewer signals to produce the pain experience. We can become over-sensitised to pain and become overwhelmed by the pain experience to such an extent, that it becomes our new ‘normal’. At this point the pain messaging system has malfunctioned, because it is trying to protect us from something that no longer exists.
 
* NIH. National Institute of Neurological Disorders and Stroke – Pain 2024 [Available from: https://www.ninds.nih.gov/health-information/disorders/pain.
 
** Baller EB, Ross DA. Your system has been hijacked: the neurobiology of chronic pain. Biological psychiatry. 2017;82(8):e61-e3.
Is chronic pain 'all in their heads'?

No, chronic pain is very real and should never be dismissed as such. Chronic pain is a condition defined by the IASP, being recognised by the latest revision of the WHO‘s ICD*.

Chronic pain is classified into two main categories:

  1. Chronic Primary Pain – where there’s no medical condition that directly causes the pain, the chronic pain is considered the disease itself. E.g., fibromyalgia, complex regional pain syndrome (CRPS), chronic migraine and chronic low back pain.
  2. Chronic Secondary Pain – where the pain is a symptom of an underlying medical condition, the chronic pain is considered a consequence of another illness. E.g., chronic pain relating to cancer, arthritis, nerve damage and surgery.

The classification above, aims to improve the representation of chronic pain conditions in primary healthcare and facilitate better diagnosis, treatment, and research in pain management. And yes, it is possible for both categories of chronic pain to occur simultaneously.

* International Association for the Study of Pain. (2021). Definitions of Chronic Pain Syndromes. International Association for the Study of Pain (IASP). https://www.iasp-pain.org/advocacy/definitions-of-chronic-pain-syndromes/

Neurofeedback

What is EEG?

Electroencephalography (EEG) is a non-invasive technique used to record the electrical activity of the brain. This activity is generated by the billions of neurons that make up the brain. By attaching electrodes to the scalp, EEG can measure and record these electrical signals, which are then visualized as waveforms on a computer screen.

* Niedermeyer, E., & Lopes da Silva, F. H. (2005). Electroencephalography: Basic principles, clinical applications, and related fields. Lippincott Williams & Wilkins.

What is EEG neurofeedback?

EEG Neurofeedback is a non-invasive technique that helps train the brain to improve its function. It uses sensors on the scalp to measure brainwave activity and provides real-time feedback to help the brain learn to regulate itself.

Is EEG neurofeedback safe?

Yes, EEG neurofeedback is generally considered safe. It’s a non-invasive technique that doesn’t involve any electrical stimulation or medication. The sensors placed on the scalp merely measure brainwave activity, providing feedback to help the brain self-regulate.

Axon

Check out more FAQs about Axon on our Technical Support page

How does Axon work?

Axon uses EEG neurofeedback to change the way the brain responds to pain. Brain activity is recorded by Axon’s custom-designed EEG headset and sent to an app to provide feedback. The feedback is displayed in such a manner as to reward users for being in a mental state that encourages their brain to moderate pain more effectively. This process is called neuromodulation and it’s how Axon is able to retrain your brain to reduce your pain.

Does Axon have any side effects?

Because Axon is a passive device, there are almost no side effects. However, some patients might feel tired after a session or a little fatigued or have a mild headache after concentrating for the 30 minute session. No lasting or serious side effects have ever been reported.

Does Axon get rid of my pain or just mask it like painkillers?

Neither. Pain is a sensation that our brains generate in response to a perceived danger to our bodies. Axon trains the brain to respond more appropriately to the nerve signals going to your brain which results in perceiving and therefore experiencing less pain. The reduction in pain is very unique to everyone. If you have concerns, you should consult your specialist to understand if you may benefit more using Axon in conjunction with other treatments such as physcial therapy, cognitive behavioural therapy or medication.

Is Axon FDA registered?

Yes. Axon is an EEG biofeedback (neurofeedback) system, comprised of an EEG headset and a software application that provides visual and auditory signals corresponding to the status of brain activity. The Axon System is a battery-powered device indicated as an adjunctive treatment for chronic pain and anxiety, to be used together with other pharmacological and/or non-pharmacological interventions. Axon meets the FDA definition of a Biofeedback Device according to §882.5050, with neurofeedback being the provision of EEG biofeedback.

Table of contents

00.

Intro

Neurofeedback Therapy is a form of rehabilitation therapy. Patients suffering from issues such as stroke, cardiac arrest, or major surgery often have to go through rehabilitation therapy to help them recover. Neurofeedback therapy can also be used for rehabilitation either on its own or as part of a wider treatment plan.

Rehabilitation therapy, including neurofeedback therapy, is also used to help patients recover from addictions to substances such as drugs, alcohol, and even food addiction.

Neurofeedback is particularly useful when treating these kinds of disorders because it can teach patients to break bad habits by influencing brain function.

Neurofeedback Therapy has also been used as a treatment for attention-deficit/hyperactivity disorder (ADHD), epilepsy, anxiety, depression and insomnia.

The aim of any rehabilitation therapy is to help patients get back to a relatively normal, independent, and high standard of living free from pain, impairments, or addictions. It can also be used to train patients to improve their capacity for mobility, speech, or cognition.

Whatever the underlying problem, neurofeedback (or biofeedback) as a means of rehabilitation therapy can play a critical role in helping patients recover from a wide range of medical issues.

01.

What is EEG Neurofeedback?

Just like other parts of the body such as our muscles, our brains have the ability to be trained and change the way they function. The question then, is: how can we help the brain to change itself? The trick to getting our brains to change is to point it in the right direction, and then it will make the changes itself. Just as we can learn a new skill, our brain can also learn and change so that it works in the best way for each person. One of the ways the brain can do this is through a scientific method called Operant Conditioning.

Operant Conditioning works by redirecting brain activity that has gotten into a negative state, into a positive, state and then reinforcing that positive state with positive feedback, until the brain learns to do it automatically. Through Operant Conditioning, people can learn to respond differently to the nerve signals that their brain interprets as pain – in essence, to ‘retrain’ their brains.

Neurofeedback uses Operant Conditioning to redirect brain activity away from predicting and experiencing pain and towards predicting and experiencing relaxation, positivity and sustained focus. This is done by using a simple interface, such as a video or animated game.

When we generate the desirable brain activity, we are rewarded with audio and visual feedback that keeps the game moving and achieving goals that help to redirect our brain to the desired frequencies associated with relaxation, positivity and sustained focus. Repeated sessions of Neurofeedback training can result in long-lasting changes in brain activity, which can affect how the brain functions and how it is structured. These changes can help the brain to send and receive different messages about pain, and these new messages can have positive effects on our perception of pain, which in turn helps improve our sleep, our mood and our behaviour.

EEG (short for Electroencephalography) Neurofeedback works by monitoring the brain activity associated with a particular function – in this case, detecting and responding to pain. This brain activity takes the form of electrical signals. Through the use of small sensors placed on the scalp (either directly or within an EEG headset), these signals can be recorded and fed back to the person in real-time via games, creating a positive feedback loop to change how the brain perceives and responds to pain.

The science of electroencephalography (EEG) has been around for almost a century. It has been used in Neurofeedback treatments since the early 1960’s (including by NASA) and it has been an established part of clinical evaluation and treatments since the 1970s. Every major hospital and medical university has an EEG system for monitoring brain activity. EEG neurofeedback uses that same technology to help the brain to change itself.

02.

How does Axon work?

Axon uses Neurofeedback to change the way the brain responds to pain. With a chronic pain patient, their brain is continually receiving nerve signals that it responds to by sending messages telling their body to experience pain. The brain activity associated with pain is recorded by Axon’s custom-designed EEG headset. Axon transmits these recordings via Bluetooth to the Axon app which then visually represents it to the patient via neurological exercises in the form of simple animated games. These exercises are specially calibrated to encourage the patient’s brain to spend less time generating the brain frequencies associated with chronic pain, which in turn encourages their brain to moderate the pain instructions it transmits and receives. By using the Axon system on a regular basis (about 30 minutes per day) over the course of several weeks, the patient learns how to ‘retrain’ how their brain perceives and responds to pain. This process is called “neuromodulation”.

03.

Does EEG Neurofeedback get rid of the pain or just mask it?

Neither. Remember, pain is a sensation that our brains generate in response to a perceived danger to our bodies. Neurofeedback trains the brain to respond differently to the nerve signals that are received from, and sent to, the body. So, if we can train our brain well through Neurofeedback, it won’t pay as much attention to the pain signals, and it won’t send the same ‘pain’ messages to our body. The result? The pain we experience is reduced.

04.

Why aren’t Neurofeedback treatments more available?

Conventional EEG Neurofeedback is complicated and costly for both patients and clinicians. It requires the patient to attend a specialist clinic for multiple sessions over 8-12 weeks, an expert clinician must be present to interpret the brain activity data, and the EEG Neurofeedback equipment has (until recently) cost many thousands of dollars to purchase. These complications have also limited the amount of clinical research that has been undertaken to test the effectiveness of Neurofeedback as a therapy not just for chronic pain, but for a range of other neurological conditions. Without this clinical research evidence, many doctors have been reluctant to recommend that patients undertake an expensive process that is difficult to access, and many patients were unable to afford the treatments.

05.

Is EEG Neurofeedback safe?

Axon is a non-invasive device. It measures brain activity by using two soft sensors on the scalp and does not impart any energy on the patient and so is completely safe to use.

06.

Are there any side effects?

Because Axon is a passive device there are almost no side effects however some patients might feel a little fatigued or have a mild headache after concentrating for the 30-minute session. No lasting or serious side effects have ever been reported from using Axon.

01.

What is Neurofeedback Therapy?

Neurotherapy or neurofeedback is a type of rehabilitation therapy designed to teach the brain to respond differently to triggers. By measuring brain activity levels using EEG technology and responding to it, neurofeedback therapy can be a powerful tool to help reinforce positive behaviour and habits.

It is a type of biofeedback, which is a mind-body technique that aims to help patients gain or regain voluntary control over certain bodily functions that are typically involuntary. This might include heart rate, muscle contraction or brainwaves for example.

As a recognised rehabilitation therapy, Neurofeedback Therapy is used to help teach self-control of brain functions. This is done by indicating to patients how their brains react to certain triggers. Once a patient understands those triggers, they can learn to recognise over time when their brain is in a certain state. They can then learn to recreate the desired state through brain training, helping them to achieve relaxation and learning to avoid unwanted states like agitation or anxiety.

02.

How does Neurofeedback Therapy work?

The fundamental technology behind Neurofeedback Therapy is electroencephalography (EEG). EEG technology has been around since the 1920s and involves the use of electrodes placed on the scalp to measure brain activity.

Since brain cells (axons) communicate through the use of electric signals, these electrodes can pick up this activity and present it as an electroencephalograph. This brain activity appears in the form of brain waves, a series of up and down movements corresponding to the intensity of brain activity.

Neuroscientists and other medical experts have been studying EEGs for decades and have derived a lot of useful information. For example, specific brainwave patterns have been associated with distinct mental states:

Beta Waves

Are associated with active engagement and a state of arousal/being awake.

Alpha Waves

Represent non-arousal and are associated with restfulness and relaxation.

Theta Waves

Are associated with an even deeper state of relaxation or “day-dreaming”. They occur when the brain is on autopilot, such as when driving down a freeway.

Delta Waves

Are associated with the deepest state of restfulness. They are associated with dreamless sleeping.

By understanding the brain activity through an EEG, it is possible to target specific conditions such as stress and anxiety, by targeting the alpha waves or improving characteristics like attention and focus that are often associated with ADHD by targeting beta waves.

Neurofeedback therapy monitors your brain for brainwave activity and almost immediately provides feedback, often through visual or audio cues. It may take several months to see the desired improvements from Neurotherapy Therapy, however, it is possible to monitor progress over time.

03.

Quantitative EEG (qEEG) and Neurotherapy Feedback

To now, we have looked at a very basic understanding of brain function. Neurosurgeons can use EEGs to diagnose mental conditions such as epilepsy, seizure disorders, ADHD, brain death, head injuries, brain death, and sleep disorders.

To be able to treat brain disorders using neurofeedback, a higher level of brain mapping is required. This is possible through the use of quantitative EEG (qEEG) technology. Scientists discovered that complex mathematical models such as wavelet (Fourier) analysis could be used to analyse and even predict brain function.

Using modern computers, experts used EEG data from millions of patients to help figure out “normal” and “abnormal” brain function. Modern computer models can continue learning from such data through machine learning (ML).

Neurofeedback Therapy takes this revolutionary qEEG technology to give feedback to patients using auditory or visual cues. For instance, when the system detects signs of anxiety or withdrawal symptoms, the feedback mechanism issues a change in sound or visual such as a brightening or dimming of a screen.

Through repetitive training, the brain can be “taught” to recognise and reject negative behaviour and emotional triggers. Experts trained in Neurotherapy and addiction can use this form of rehabilitation therapy to gauge improvement as the treatment goes on.

Who might benefit from Neurotherapy Therapy?

04.

What does a typical Neurofeedback Therapy session look like?

Neurofeedback Therapy is more common than a lot of people might think and is becoming more prevalent as a way of treating a wide range of brain-based conditions.


A typical Neurofeedback Therapy session will typically follow these steps:

1. Set goals for the treatment – Depending on the patient’s condition and type of neurofeedback system, goals will be set at the start of a session. For example, a patient suffering from anxiety will be set the goal of regulating fast brain wave activity (beta waves) so that they can feel calmer and more relaxed after the session.

 

2. Measure brain wave activity – in a traditional Neurofeedback Therapy session, electrodes would be placed onto a patient’s scalp to measure brain wave activity (i.e. EEG). After the EEG has been fitted, a patient will then be asked to carry out tasks as the Neurofeedback Therapy begins. This might be watching a movie, playing a game or conducting a series of tasks.

 

3. Train the brain through positive feedback – depending on the task that the patient has been set, when the EEG detects that the patient has met the desired goal, they will be rewarded with positive feedback. This might be a high score in a video game, improved lighting on a movie or a positive audio signal. This positive feedback is an essential part of training the brain.

 

4. Repeat training exercises – during a single Neurofeedback Therapy session, the brain might be given thousands of opportunities to self-correct and be rewarded. It is part of the on-going process of training the brain and the positive feedback helps to reinforce the positive actions taken by the brain during the session.


This repetition and reward cycle has been found to be the most effective way to train the brain, as we constantly seek rewards for positive behaviour.

05.

What can Neurofeedback Therapy Treat?

We have already touched upon some of the individual conditions that Neurofeedback Therapy can be used to treat, however, these can be part of a wider group of conditions that include:

  • Mental Health Issues and Psychiatric Disorders

    This includes conditions such as mood and anxiety issues, OCD, panic attacks, or PTSD

    Neurofeedback Therapy can help patients to feel calmer, happier and safer. As we have already discussed, targeting beta waves for people suffering from anxiety and increasing alpha waves can really help to induce a state of calmness in these patients.

  • Developmental Delays and Behaviour Disorders

    This includes conditions such as ADHD, ASD, or PANS/PANDAS

    In the case of developmental disorders, such as autism in children, for example, the brain does not develop the proper networks for communication. Neurofeedback Therapy can significantly change these communication networks and help to improve behaviour over time.

  • Neurological Issues and Brain Injuries

    This includes those who have had a stroke, Parkinson’s, a traumatic brain injury (TBI), or tinnitus

    Whilst Neurofeedback Therapy may not have all the answers when it comes to treating some of these conditions, it does provide hope for new ways of healing, especially when combined with new, integrative approaches to medicine.

  • Improved performance

    Includes athletes, executives and students who want peak performance

    Whilst Neurofeedback Therapy is often used as a reactive treatment for specific conditions, it can also be used proactively by those seeking peak performance including athletes, top executives, and students. Neurofeedback Therapy can be used to exercise the game and prepare individuals for a big game, an important meeting or exams.

06.

Is Neurofeedback Therapy safe?

Because neurofeedback is a non-invasive treatment as well as a form of exercise for the brain, it is generally considered safe without significant side effects.

Some side effects have been recorded after Neurofeedback Therapy, however, these tend to be short-term, typically lasting only 24-48 hours. Recorded side effects include drowsiness, lack of focus, mild headaches, and anxiety. It should be noted, however, that these side effects are rare.

If you do suffer from any side effects while undergoing Neurofeedback Therapy, these should be reported so that your training can be modified accordingly.

07.

Where Axon Comes in

Neurofeedback Therapy relies on two important technologies to work: EEG for measuring and recording brain activity, and a feedback mechanism to train the brain to adopt good habits.

The feedback mechanism relies on a complicated computer algorithm that sends the right cues at just the right times to influence brain activity.

Here at Exsurgo, we have redefined Neurofeedback Therapy thanks to our revolutionary Axon system. Axon is a miniaturised headset designed and produced by our top neuroscience engineers for advanced EEG brain monitoring and analysis.

Whilst EEGs are typically very complex and expensive machines found in hospitals, Axon is both easy to use and affordable, making it an option for the average consumer as well as medical practices.

What makes it so different is the use of cloud-based technology, which means that the part that does all the heavy lifting (processing EEG data) doesn’t have to be on the Axon headset itself.

With that simple tweak, Axon becomes incredibly easy to use with just a simple mobile app while retaining its medical-grade sensitivity and functionality.

08.

Axon for Neurofeedback Therapy

Anyone suffering from chronic pain, ADHD, PTSD, depression, migraines, and other types of brain disorders can use Axon, either in our clinic or at home to treat themselves using Neurofeedback Therapy.

Axon is particularly attuned to the treatment of chronic pain. After extensive proprietary research and ongoing clinical trials, Axon has shown significant improvements in the intensity of pain.

During the UK clinical trial, Exsurgo’s Axon EEG headset showed a lot of promise in being able to get patients off powerful opiate meds while helping them reclaim their quality of life.

Since neurofeedback therapy is non-invasive and almost free from health risks, the Axon is an exciting option that is open to anyone who wants to heal and transform their life for the better.

09.

Sign Up for a Clinical Trial

Clinical trials on chronic pain treatment using the Axon are still ongoing. The UK trial was successful, and the team at Exsurgo is already working on the Auckland Trials in New Zealand with the Waitemata District Health Board, and later in the US.

 

If you would like to be part of this exciting opportunity please contact the team at trials@exsurgo.com and we will get back to you.

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