Comprehensive Guide to Pain Management and Durable Medical Equipment

To submit this form, gather all required information and fill out each section accurately. You can submit the completed form via email to info@nationalspine.com, fax it to (123) 456-7890, or use the online submission form at NationalSpine.com. Alternatively, you can mail the form to National Spine & Pain Centers, 123 Pain Management Rd., Suite 456, Medical City, ST 78901. Review the submission guidelines for any additional instructions or requirements. Ensure all information is accurate to avoid delays in processing.

The purpose of this document is to provide comprehensive information on pain management techniques and the use of durable medical equipment. It aims to educate patients, healthcare providers, and caregivers on various non-surgical treatments available for managing chronic pain. Additionally, the document serves as a guide for selecting appropriate medical equipment that can aid in pain relief and improving quality of life.

• 1. Aspen Evergreen™ 621 SI Belt: The Aspen Evergreen™ 621 SI belt is a low-profile and lightweight brace designed to relieve SI dysfunction and provide sacrum stabilization.
• 2. Aspen Horizon™ 456 TLSO: Aspen's Horizon™ 456 TLSO is designed to restore patients to a functional position that relieves pressure on back muscles, improves balance, and increases vital capacity.
• 3. Aspen OTSTM LSO 650: The Aspen OTSTM LSO 650 offers clinically proven technology for patients experiencing low back pain, combining support and compression to promote effective pain therapy.
• 4. Aspen Peak Scoliosis Bracing System™: Designed specifically for adult scoliosis patients, this system reduces pain, increases mobility, and promotes better posture.
• 5. Össur Formfit® Ankle Brace w/ SpeedLace: The Formfit® Ankle Brace provides stability and protection for the ankle, with a low-profile design that fits comfortably into shoes.
• 6. Össur Formfit® Night Splint Posterior: This night splint helps relieve pain associated with plantar fasciitis by providing a gentle overnight stretch.
• 7. Össur Unloader One®: The Unloader One® brace reduces pain, improves function, and decreases the use of pain medication with its lightweight and low-profile design.
• 8. Össur Formfit® Thumb Spica 8": Designed to restrict wrist and thumb motion, this brace provides immobilization and protection for patients with tendinitis and soft tissue injuries.
• 9. Össur Formfit® Wrist Brace 8": The Formfit® Wrist Brace offers immobilization and protection for tendinitis and soft tissue injuries, with lightweight and breathable material for comfort.
• 10. Össur Rebound ROM Knee Brace: Provides knee joint stability, protection, and compression to treat mild or moderate ligament pain, sprains, and strains.
• 11. Össur Unloader® Hip Brace: Designed to reduce pain and optimize load dispersion for patients with mild to moderate hip osteoarthritis, improving hip stability and mobility.
• 12. TENS Unit: A device that sends low-voltage electrical currents to targeted body parts to relieve pain.
• 13. Vista® MultiPost Therapy Collar: Aspen's Vista® MultiPost Therapy Collar helps re-establish natural neck alignment to reduce symptoms associated with poor neck posture.
• 14. Vista® TX Collar: Designed to restrict flexion, extension, lateral bending, and axial rotation of the neck.
• 15. Theratrac Cervical Traction: This device relieves discomfort in the neck and shoulder area caused by cervical or spinal disc abnormality.

Failing to submit this form can result in a lack of access to essential pain management treatments and equipment. Patients may experience prolonged pain and discomfort without the specialized support provided by these resources.

• Prolonged Pain: Without access to recommended treatments and equipment, patients may suffer from extended periods of pain.
• Limited Mobility: Failure to use appropriate bracing systems can result in decreased mobility and difficulty performing daily activities.
• Increased Medical Costs: Not submitting the form may lead to increased healthcare expenses due to the need for alternative treatments or interventions.

• 1. Chronic Pain Management: Patients experiencing chronic pain can use this form to explore treatment options.
• 2. Post-Surgical Rehabilitation: Individuals recovering from surgery may find valuable information on supportive equipment.
• 3. Physical Therapy: Physical therapists can reference this document for equipment recommendations.
• 4. Consultation with Healthcare Providers: Use this form during medical consultations to discuss potential pain management solutions.
• 5. Insurance Approval: Insurance providers may require this form to approve and cover specific treatments.