Are you supposed to feel exogen bone stimulator? The Sensation Explained

While 5–10% of all fractures may experience delayed or non-union healing, the Exogen system offers a painless, non-invasive treatment. Many patients wonder, are you supposed to feel exogen bone stimulator? The answer, for most users, is little to no sensation during the daily 20-minute therapy.

Quick Summary

Most patients feel minimal to no sensation from the Exogen bone stimulator, which uses low-intensity, painless ultrasound waves to accelerate fracture healing. Any mild tingling is typically harmless, while a complete lack of sensation is normal and does not indicate device malfunction.

Key Points

• Normal Sensation: Most patients feel absolutely no sensation during Exogen treatment, as the technology works at a cellular level not felt by the body.

• Subtle Tingling: A small percentage of users may experience a minor tingling, which is considered normal and is not a sign of device malfunction or pain.

• No Sensation is Normal: The lack of feeling is an intended feature of the painless, low-intensity pulsed ultrasound (LIPUS) technology, which stimulates healing at the biological level.

• Gel Sensitivity: In rare cases, minor skin irritation may be caused by the coupling gel. This can often be resolved by switching to an alternative, like mineral oil.

• Device Indicators: The Exogen device uses audible beeps to confirm proper operation and therapy completion, so patients should rely on these signals rather than a physical sensation.

• LIPUS vs. PEMF: Exogen uses ultrasound waves (LIPUS), which generally produce no sensation, while other bone stimulators use pulsed electromagnetic fields (PEMF), which also typically produce no feeling.

What to Expect: The Normal Sensation During Treatment

For the vast majority of patients using the Exogen Ultrasound Bone Healing System, the treatment is a sensation-free experience. The device works by emitting a low-intensity, pulsed ultrasound (LIPUS) signal to the fracture site, which occurs at a cellular level that the human body does not register as a physical feeling like heat, vibration, or pain. The absence of sensation is a key feature of the therapy, not a sign that it is not working. The entire treatment is designed to be painless and convenient, fitting easily into a patient's daily routine.

A small percentage of users may report a minor tingling sensation at the treatment site during a session. This is not a cause for concern and is not associated with pain. The tingling is likely the result of the body's subtle response to the pulsed waves or skin sensitivity. In rare cases, some patients have reported minor skin irritation from the coupling gel used with the device. If this occurs, switching to an alternative such as mineral oil or glycerin, as advised in the user guide, can resolve the issue.

The Science Behind the Treatment's Lack of Sensation

The reason the Exogen therapy feels like nothing at all comes down to its mechanism of action. The low-intensity pulsed ultrasound waves are engineered to penetrate the skin and soft tissue to a very targeted area. At the fracture site, these waves trigger a process that:

• Stimulates Cellular Movement: The ultrasound waves create subtle mechanical motion that stimulates the cells vital for bone repair.
• Activates Healing Cells: This motion activates specific cell receptors, which initiates a cascade of biological reactions essential for bone growth.
• Upregulates Healing Factors: The therapy increases the body's natural production of factors and proteins that are critical to the bone remodeling process.

This entire process is microscopic and biologically driven, not a physical stimulation that would produce a noticeable physical sensation. Unlike other medical therapies that can be felt, such as transcutaneous electrical nerve stimulation (TENS) or deep tissue ultrasound, the LIPUS technology operates below the sensory threshold of nerves, ensuring a comfortable and unobtrusive treatment experience.

Comparison of External Bone Stimulator Technologies

Different types of external bone stimulators utilize distinct technologies to achieve healing. The following table compares the LIPUS technology used by Exogen with the Pulsed Electromagnetic Field (PEMF) therapy used by other devices, such as those from Orthofix, regarding the sensation experienced during treatment.

Feature	Exogen (LIPUS)	PEMF (e.g., Orthofix devices)
Mechanism	Emits low-intensity pulsed ultrasound waves.	Delivers a pulsed electromagnetic field.
Sensation	Little to no sensation felt. Some may feel a mild tingling.	Typically no sensation is felt during therapy.
Patient Comfort	Very high; device is small and portable, and treatment is painless.	High; devices are often lightweight and can be worn discreetly.
Energy Type	Acoustic (mechanical waves).	Electromagnetic.
Treatment Duration	A single 20-minute session per day.	Varies by device and condition; can be hours per day.

A Checklist for Proper Exogen Usage

To ensure your Exogen device is functioning correctly and delivering the silent, painless treatment as intended, follow these steps during your daily session:

1. Prepare the transducer: Apply a generous pump of the coupling gel onto the smooth side of the transducer head. This is crucial for sound wave transmission.
2. Position the device: Secure the transducer head directly over the treatment site, which may be marked by your doctor. If a cast is present, the transducer is placed in the designated port.
3. Check for proper contact: Ensure the transducer is firmly in place. The device has sensors to detect improper placement and will alert the user if contact is lost.
4. Listen for activation: The device will beep to confirm the start of the 20-minute treatment. It will also signal when the treatment is complete.
5. Monitor the battery: The device's display shows the battery charge. Charge the unit as needed to avoid interruptions in treatment.

Conclusion

In summary, the normal experience with an Exogen bone stimulator is to feel nothing at all during the 20-minute daily therapy. The treatment's effectiveness is not dependent on a physical sensation but rather on the subtle, cellular-level effects of low-intensity pulsed ultrasound. While a mild tingling can occur for some patients, it is not a sign of pain or malfunction. If you feel anything unusual or painful, or have concerns about your device's operation, it is best to consult with your doctor or contact the manufacturer's customer service for troubleshooting. The Exogen system is designed to be a simple, safe, and sensation-free path toward promoting natural bone healing.

For more detailed information on the device and proper usage, please consult the official Bioventus resources or your healthcare provider. Bioventus - Exogen Information

Frequently Asked Questions

Is the Exogen bone stimulator still working if I can't feel anything?

Yes, absolutely. The low-intensity pulsed ultrasound (LIPUS) technology used by Exogen works at a cellular level that is not perceptible to human touch. The absence of sensation is normal and is not an indicator of device malfunction. The device's display and beeps will confirm that it is working correctly.

What if I feel a tingling sensation during treatment?

A mild tingling is reported by some patients and is generally not a cause for concern. If you feel a mild tingling, it is likely a benign response to the therapy. If the sensation is uncomfortable or painful, you should stop treatment and contact your doctor or customer service.

How do I know if my device is working correctly?

The Exogen device provides audible beeps to indicate that a treatment session has started and completed successfully. You can also check the display for proper function and battery level. If the device alerts you to an improper application, follow the user guide's instructions for correct placement.

Can I use the Exogen device over a cast?

Yes, the device can be used over a cast. Many casts are equipped with a port or opening to ensure the transducer head can be secured directly over the skin at the fracture site. It is important to apply the coupling gel directly to the skin via this port.

What if I experience skin irritation from the gel?

Some patients have a sensitivity to the ultrasound gel, which can cause mild skin irritation. The manufacturer's user guide suggests using a hypoallergenic alternative like mineral oil or glycerin if this occurs.

How is Exogen different from other bone stimulators?

Exogen uses low-intensity pulsed ultrasound (LIPUS), while other devices, like those from Orthofix, may use pulsed electromagnetic fields (PEMF). Both are non-invasive, but they use different energy types to stimulate healing. The sensation is typically minimal or non-existent with both types of external devices.

Is it safe to use Exogen with internal fixation hardware?

According to the manufacturer, Exogen can be used by patients with internal or external fracture fixation hardware. However, the device should not be applied directly over the metal hardware, as the ultrasound waves cannot penetrate it.