Chronic pain affects a huge 10% of the world’s population! Medical professionals are working to develop more effective treatments to reduce pain and improve the quality of life for pain patients.
Many treatments use mild electrical currents to stimulate the nerves, leading to pain reduction. Quell is one of these treatments. We’ll take a closer look at what Quell is, how it works, and how to use it effectively.
What is Quell?
Quell is a wearable pain relief device. It uses nerve stimulation to reduce pain. The device is non-invasive and doesn’t hurt.
Quell is a type of transcutaneous electrical nerve stimulation (TENS) machine, although the company states that their Quell 2.0 device is between 3x and 5x more powerful than a typical over-the-counter TENS machine. Quell is also only attached at one point of the body, while a traditional TENS machine usually has two to four electrodes attached in different places.
Quell was created by a company called NeuroMetrix based in America. They were founded in 1996 by Dr. Shai N. Gozani and have since worked to develop neurodiagnostic and wearable products.
There is a classic Quell machine; a Quell 2.0, and a Quell Fibromyalgia. Quell 2.0 is a newer and stronger device than the classic. Quell Fibromyalgia is designed specifically for patients with fibromyalgia who have a higher pain sensitivity. It has a slightly lower pulse duration and voltage, so it’s gentler on the patient.
How Does Quell Work?
The Quell device slips into a band that attaches around your leg. It has an electrode that you attach to the inside of the band, so it makes contact with your skin. The electrode is attached to the main device. The device is like the ‘brain’ that controls how Quell functions.
The device can be controlled by buttons on its side, or by an app on your smartphone connected via Bluetooth. The app also has some tracking features that can be useful, such as sleep and activity tracking as well as a place to record your pain levels.
When Quell is activated it sends out low voltage electrical impulses which stimulate the nerves under the skin. Specifically, there are a group of peripheral sensory nerves in the calf where Quell is placed which are stimulated during treatment. This is thought to ‘interrupt’ pain signals and prevent them from being sent to the brain.
This 2020 article explains that devices like this: “deliver a mild level electric current (e.g. <100 mA) through the skin to interfere the transmission of pain signals by exciting sensory nerves and stimulate the production of endorphins – the bodies’ natural painkiller.”
This type of stimulation can also stimulate opioid receptors, inducing natural pain relief without the use of oral drugs. A study from the Journal of Pain Research explains that: “High-frequency stimulation induces an elevation in enkephalins that act through the δ-opioid receptor, whereas prescription opioids primarily act through the μ-opioid receptor “. Both receptors provide pain relief.
However, some research suggests that this type of stimulation works due to a placebo effect. This 2022 randomised double-blind sham-controlled trial on 119 patients with fibromyalgia (FM) gave one group a Quell machine and another a sham machine (essentially a placebo). They found that there were: “no differences between those who were exposed to maximal-frequency active stimulation or minimal-frequency sham stimulation from a wearable TENS in reducing FM-related symptoms.”
Who Can Use Quell?
Most adults with chronic pain can use Quell. However, you won’t be able to use it if you have an implanted metal or electronic device, like a pacemaker. It can interfere with how other devices work and can be dangerous.
You also shouldn’t use Quell at the same time as any electronic monitoring devices, for example, if you’re having an ECG or are wearing a cardiac monitor. It can stop them from working properly.
Quell doesn’t work for headaches and can’t be used on the head. You may not be able to use the device during pregnancy but should talk to your doctor about this for further guidance.
If you have heart disease, epilepsy, or any condition that causes a risk of internal bleeding you should be able to use Quell but you must chat with your doctor first to make sure it’s safe for you.
The company states that all models of Quell are FDA-approved to treat chronic pain. Quell used to be available over the counter. However, now, Quell and Quell Fibromyalgia have to be prescribed by a doctor and you must pay for it yourself. It’s available in America and the company is working on making it more widely available in the UK and Europe.
Of course, this means you need to take the cost into account. The electrodes also need to be replaced regularly, which is an additional cost.
Potential Benefits of Quell
There are several potential benefits from using Quell. We’re all different so it’s important to note effectiveness may vary depending on the person.
Of course, the main benefit of Quell is that it has the potential to reduce chronic pain levels. In turn, this can increase mobility and allow patients to be more active, improving quality of life.
This large-scale, observational study found that when using a high-frequency TENS device (like Quell) for two months, patients experienced: “statistically significant reductions in average pain intensity and pain interference with sleep, activity, and mood.”
Another study on the use of Quell for lower back and lower extremity pain found that of 88 patients using the device for 60 days: “80.7% of participants reported an improvement in their chronic pain and overall health.”
The device can be worn all day and night if needed, which can provide long-term pain relief. Pain relief can last for around an hour between each ‘session’.
Many pain patients struggle with the not-so-affectionately named painsomnia (insomnia caused by pain levels). Since Quell can be worn during the night, it could potentially reduce pain at bedtime and improve sleep quality.
Interestingly, evidence also suggests that consistent use of Quell may help to reduce pain catastrophizing. Pain catastrophizing refers to patients having a very negative thinking pattern about their pain, including fearing their symptoms. Catastrophizing and fear of chronic pain have been linked to higher pain levels and lower levels of functioning.
A 2019 study on Quell for lower back pain found that after three months of use, patients reported lower pain scores and: “significantly lower pain catastrophizing scores.”
It can take a few days or even weeks to start feeling pain relief from Quell, although this will differ depending on the individual and their symptoms. Don’t get disheartened if it doesn’t work right away – keep following the instructions and be consistent.
Quell isn’t designed to ‘cure’ chronic pain or address the root cause. You can think of it more like a sort of dimmer switch, designed to ‘turn down’ the severity of your pain to make it more manageable.
Reduced Need for Painkillers
If Quell works well for an individual and markedly reduces their pain, they may be able to reduce their intake of painkillers. This is positive because painkillers act systematically which means that they can have some side effects.
This article on wearable pain treatments states that: “two-thirds of Quell users reported a reduction in use of pain medication while using the device.”
Can Be Worn During Activity or Sleep
Quell can be used at home as part of your usual routine. This makes it a very accessible and practical treatment.
The Quell device is strapped around your calf and doesn’t have any loose wires or components, so you can wear it during your usual daily activities or exercise without any issues. There’s even a ‘gentle overnight’ setting designed to provide appropriate pain relief without disturbing your sleep.
It functions automatically once you have set it up, so you don’t have to worry about activating pain relief sessions or changing settings – you can just get on with your day.
This 2020 article explains that Quell has been made more practical by: “integrating the electrodes and electronic control into a single unit to improve the usability.”
Can Be Used With Other Treatments
Quell can be used alongside most other chronic pain treatments safely. Evidence is limited on the effectiveness of using Quell with other chronic pain treatments but logically, it makes sense that combining other treatments would have improved outcomes.
Other treatments may include:
- Over-the-counter or prescribed painkillers
- Talking therapies
- Manual therapies (like massage and physiotherapy)
- Mindfulness-based therapies
- Pain management clinics or online pain management programmes like Pathways Pain Relief
Few Side Effects or Risks
When Quell is used as instructed, there are very few side effects. It doesn’t act systemically, which means it doesn’t have any side effects in other areas of the body. The main potential side effect is skin irritation caused by the band or the gel on the electrodes.
It’s best not to leave the device on all the time, as this is more likely to cause skin irritation. You might want to start with three or four-hour blocks at first to see how your skin reacts and go from there. You can choose to alternate between legs to give your skin a break. The manufacturers recommend ‘airing out’ your skin every five hours or first thing in the morning if you’re sleeping with it on.
Another risk is simply that Quell may not work for you. It doesn’t work for everyone. However, for many patients, it may be worth a try.
How to Use Quell
When you receive your device, it comes with an adjustable sports band and the Quell sits in a sort of ‘pocket’ on the outside of the band. The electrode attaches to the inside of the band so it makes contact with your skin. The electrode needs to be changed roughly every two weeks.
You attach the band to your upper calf one to two inches below your knee with the lights on the device at the top. It simply wraps around your leg and secures with velcro.
You can start the device by clicking the button on the machine itself or via the app on your phone. The instructions that come with the device will take you through calibrating your device, which simply involves clicking the button when you feel a tingling sensation.
Once your device is set up, you’re ready to go! Each time you start it, the device will stay active for 60 minutes. You can manually stop or start it at any time. You can also increase or decrease the intensity of the electrical signals to suit your needs. It won’t cause pain but may feel like a pulse, vibration, or tingling sensation.
For the most effective pain relief, your goal should be to have the intensity as high as possible while being comfortable for you. We’re all different, so different intensities will feel right for different people.
If the Quell device is left to operate itself once turned on, it will automatically run its pain relief sessions every other hour. You can wear the device for as long as you need to. You can’t swim or go in the shower or bath while wearing the device, but it’s easy to remove and put back on when needed.
The Quell is powered by a rechargeable battery. Lights on the side let you know how much charge the battery has.
When it’s time to recharge it, you simply slip the device out of the pocket on the band and plug it in with the cable it comes with to charge. It takes about three hours to fully charge and the battery is long-lasting. On average it can last up to 50 sessions, which is essentially 50 hours of active use.
Is Quell for You?
If you live with uncontrolled chronic pain, Quell could be useful for you. It’s worth talking to your doctor or pain specialist about your options. They may advise you on whether Quell is a viable option, or potentially recommend other similar treatments.
- Meijing Liu, Tyler Ward, Dan Young, et al., (2020), “Electronic textiles based wearable electrotherapy for pain relief”. Sensors and Actuators A: Physical, Volume 303, 1 March 2020, 111701.
- Shai N Gozani, (2016), “Fixed-site high-frequency transcutaneous electrical nerve stimulation for treatment of chronic low back and lower extremity pain”. Journal of Pain Research, Volume 9.
- Robert N. Jamison PhD, Samantha Curran BS, Limeng Wan BS, et al., (2022), “Higher Pain Sensitivity Predicts Efficacy of a Wearable Transcutaneous Electrical Nerve Stimulation Device for Persons With Fibromyalgia: A Randomized Double-Blind Sham-Controlled Trial”. Neuromodulation: Technology at the Neural Interface, Volume 25, Issue 8, December 2022, Pages 1410-1420.
- Shai N. Gozani, M.D., Ph.D., (2015), “Science Behind Quell™ Wearable Pain Relief Technology for
- Treatment of Chronic Pain”. NeuroMetrix, Inc.
- Kong X, Gozani SN., (2018), “Effectiveness of fixed-site high-frequency transcutaneous electrical nerve stimulation in chronic pain: a large-scale, observational study.” J Pain Res. 2018 Apr 9;11:703-714.
- Robert N. Jamison PhD, Limeng Wan BS, Robert R. Edwards PhD, Anna Mei BS, Edgar L. Ross MD, (2019), “Outcome of a High-Frequency Transcutaneous Electrical Nerve Stimulator (hfTENS) Device for Low Back Pain: A Randomized Controlled Trial”. Pain Practice, Volume 19, Issue 5, June 2019,
- Pages 466-475.
- Robinson SC., (2019), “No exchange, same pain, no gain: Risk–reward of wearable healthcare disclosure of health personally identifiable information for enhanced pain treatment.” Health Informatics Journal. 2019;25(4):1675-1691.