For decades, opioids have been the go-to medication for managing post-operative and other types of pain. However, the tide is turning as the devastating consequences of opioid addiction become increasingly clear.  Athletes, known for pushing their bodies to the limit, are at the forefront of this shift, seeking out innovative, non-opioid solutions to manage pain after surgery and expedite healing. Their experiences are raising public awareness – and investor attention – about  alternative treatment options and paving the way for a future where powerful painkillers are not the only answer. 

A few public companies to evaluate now to get exposure to the future of pain treatments are Pacira Biosciences (NASDAQ: PCRX), the maker of Exparel, a long-lasting local anesthetic; Abbott Labs (NYSE: ABT), whose portfolio includes spinal cord stimulators; Neurometrix (NASDAQ: NURO), a developer of neurotechnology devices (e.g. Quell® Fibromyalgia) for chronic pain; and Endonovo Therapeutics Inc (OTCPK: ENDV), a sleeper in this group with its integrated model and clinically proven SofPulse® Pulsed Electro Magnetic Field (PEMF) product for accelerated tissue recovery and pain management.

Dire Need to Phase Out Opioids

The opioid crisis in the U.S. has reached alarming proportions. According to the National Institute on Drug Abuse, over 100,000 people died from opioid-involved overdoses in 2021. From casual church league softball players to the most elite in the world, athletes, with their frequent exposure to injuries and surgeries, are particularly susceptible to dependence and addiction.

The stories of legendary athletes like Hall of Fame quarterback Brett Favre, golf icon Tiger Woods, and WWE superstar Rob Van Dam serve as stark reminders.  These individuals, along with countless others, have battled dependence on painkillers, highlighting the dangers associated with traditional opioid-based pain management.

The tragic case of NHL left winger Derek Boogaard further emphasizes the urgency for change. Boogaard's death, linked to a combination of oxycodone and alcohol, underscores the potential for fatalities associated with opioid use.

With the growing awareness of these dangers, the "revolving door" of readily available prescription pain medication is shutting.  Pro teams are being forced to re-evaluate their approach to managing player injuries.  This shift presents a crucial opportunity – a chance to embrace innovative, non-opioid solutions that prioritize player health and well-being.

Next-Gen Alternatives are Investment Opportunities

David Irving knows a thing or two about pain. The former Dallas Cowboys defensive tackle suffered 27 concussions before the age of 26. As such, his life was an incessant battle with traumatic brain injury (TBI) symptoms, including chronic headaches and post-traumatic stress disorder (PTSD) indications. Irving now is a staunch supporter of SofPulse®, a groundbreaking technology of Endonovo Therapeutics Inc. (OTCPK: ENDV) that he attributes to finding hope and freedom from his debilitating ailments.

SofPulse® is a gentle pulsed electromagnetic field (PEMF) therapy, where targeted ultra-low microcurrents (~1,000x weaker than those emitted by a mobile phone) are transmitted to damaged tissue, helping to reduce swelling and speed up the natural recovery process. As a viable non-opioid pain reduction solution, it offers cost-effective treatments while reducing the risk of opioid dependency and addiction. SofPulse®’ is non-invasive and its ease of use makes it a convenient option for at-home or clinical use.

The FDA has cleared SofPulse® for post-operative pain and edema, indicating that it has met stringent safety and efficacy standards set by regulatory authorities. Endonovo has already established distribution channels in the U.S. Veterans Health Administration (VA) and  Department. of Defense (DoD). SofPulse® distribution into the VA represents a breakthrough in non-pharmacological pain management that can provide veterans with a safe, non-invasive alternative to traditional pain medications. This could be particularly beneficial given the current opioid crisis and the VA's commitment to finding non-addictive pain management solutions.

SofPulse® international distribution into Mexico and Taiwan holds immense promise by offering innovative solutions for pain management and post-operative care in previously unavailable markets. SofPulse®, through Taiwan FDA clearance, is set to expand distribution throughout Taiwan by improving patient outcomes and reducing healthcare costs associated with prolonged hospital stays and medication.

Endonovo has announced plans to expand international distribution to Central and South America and other Asian markets this year.

The reduction in pain provided by SofPulse®  has been validated significantly through clinical studies and research where results have proven its efficacy and effectiveness in reducing pain and swelling, a claim many medical device manufacturers cannot make. Simply, the FDA doesn’t require as stringent human data for medical devices as they do for drugs. SofPulse® targets pain reduction and its PEMF technology promotes faster recovery with fewer side effects and less medication. Its therapeutic approach sets it apart from devices that simply mask or block pain, making it a comprehensive option for post-operative care.  

SofPulse is the only FDA-cleared, non-invasive medical device offering round-the-clock, continuous pain therapy. SofPulse is programmed to administer its pain-relieving PEMF therapy continually to the site of the pain.

Most medical companies, much less a small one like Endonovo with an extremely undervalued $1.3 million market capitalization, and a $75 Million independent Valuation completed in 2018, will not take the risk of potentially failing to show any meaningful clinical benefit. 

However, Endonovo stands tall with its clinical database. To date, there have been a total of 14 PEMF studies showing efficacy utilizing SofPulse® and over 20,000 uses with no known side effects. SofPulse® works on a cellular level to remove the cause of the pain, thereby reducing edema and inflammation and accelerating recovery through enhanced blood flow and remodeling.

To lend a little color, consider a double-blind, placebo-controlled, randomized study that evaluated the impact of SofPulse® on pain and narcotic use after breast reduction and breast augmentation procedures. The results, which were published in Plastic Reconstruction Surgery, were highlighted by a 57% decrease in mean pain scores at one hour post-procedure and 300% decrease in mean pain scores at five hours and a 275% reduction of inflammation and swelling at 18 hours after surgery. The drop in pain resulted in a 2.2X-fold reduction in narcotic use in active patients.

In combination with Endonovo’s comprehensive telehealth platform, the company is positioned as a market leader with a solid competitive edge. By expanding its distribution channels and focusing on key markets, SofPulse® is positioned to revolutionize pain management and post-operative care on a global scale, benefiting patients, healthcare providers, and investors alike.

PEMF Therapy: A Growing Trend in Pain Management

PEMF  is an emerging approach gaining traction in the realm of pain management.  PEMF therapy has attracted the attention of some high-profile figures, including athletes like NBA Hall of Famer Shaquille O'Neal, 2015 MLB Cy Young winner Jake Arrieta, and NFL Hall of Famer Terrell Owens, and celebrities, including Gwyneth Paltrow and Suzanne Somers, who attributes PEMF therapy as instrumental in health in her book, “BREAKTHROUGH: Eight Steps to Wellness.”

There is little to no controversy about the safety of PEMF treatments. Lending further evidence, the International Olympic Committee has approved PEMF for use in both humans and horses, and reportedly thousands of athletes turn to PEMF. One prominent advocate for PEMF therapy is Richard W. Quick, a 6-time Olympic swim coach. Coach Quick praises the benefits of PEMF in reducing pain and stiffness, potentially improving an athlete's range of motion and performance.

Other Non-PEMF treatments and devices can be invasive, requiring injections or catheters, with limited pain reduction results and durations of use. They often have multiple contraindications, including increased risk of mortality and or death. Most non-opioid devices only offer temporary pain relief and lack FDA approval for reducing edema and swelling. PEMF solutions, like the one offered by SofPulse®, is therapeutic and by addressing the biochemical root of pain, offer a superior, drug-free solution for optimal pain and inflammation management. Additionally, SofPulse® is an excellent non-pharmalogical pain management solution for patients with a history of opioid abuse or those susceptible to such abuse.

Adoption of Alternate Therapies

Exparel, a long-acting local anesthetic administered through injection during surgery, is another non-opioid option gaining popularity.  Exparel provides targeted pain relief at the surgical site, minimizing the need for systemic opioids.  Professional golfer Bubba Watson is one athlete who has spoken about the benefits of Exparel after back surgery.

Spinal cord stimulation (SCS) is a more invasive, but highly effective technique for chronic pain management.  A device implanted near the spinal cord delivers mild electrical pulses that disrupt pain signals before they reach the brain.  An article published in Nature in November 2023 detailed an instance where SCS helped a man with Parkinson’s walk without falling.

Quell® Fibromyalgia is a thin wearable medical device that is inserted into a soft band, a disposable electrode is attached and then the band is placed on the upper calf. It is easy to use, wear and forget technology. The device comfortably stimulates sensory nerves to help relieve the symptoms of fibromyalgia without significant side effects.

The growing adoption of these alternative therapies is not just about individual recovery.  It's about raising public awareness and challenging the perception of opioids as the only viable solution for post-operative pain.  Seeing pro-level athletes, like David Irving, Shaq, and more endorse non-opioid options is highly impactful, empowering others to explore these alternatives and advocate for themselves in conversations with healthcare providers.

The end of the opioid crisis begins in the doctor’s office followed by louder megaphones trumpeting stories of successful recovery without relying on any powerful painkillers. The day is coming soon where managing pain doesn't come at the cost of addiction.  And just like any other major shift in a sector, there are going to be some big winners.

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