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The ENSO Pain Management Program is ideal for chronic back pain. Participants in the ENSO program will receive a non-invasive neuromodulation device along with coaching, monitoring and support for the 90-day program.

If you are an adult (over 18) and have had chronic back pain for more than 6 months, you will be evaluated across a number of criteria. Please fill out the questions below as an initial assessment of your eligibility for the program.

1

What is the severity of your pain on a scale of 0-10?

No pain at all

Worst pain

0=No pain at all, 10= worst pain

2

Do you have any of the following?

Pacemaker
Severe epilepsy
Implanted defibrillator
Severe cardiovascular disease
Any other electronic implanted device
None of these
Currently pregnant

3

Do you have a smart phone?


4

Which of the following have you been diagnosed with?

Degenerative disc disease
Sciatica or cervical radiculopathy
Scoliosis
None of these
Spinal stenosis

5

Which of the following pain areas are you interested in treating?

Back
Shoulder
Neck
Hip
Knee
Arm/wrist
Leg/foot
Other

6

What interests you most about ENSO? (select all that apply)

Better pain control
Better sleep
Increased productivity
Better social life
Improved physical function
Other interests
Reduced pain medication use

Please fill in the missing fields above before submitting.

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