Came back from the inaugural Pain Certification from Clinical TMS in June of this year. Both brain and peripheral neuromodulation research was reviewed, as well as the international speakers experience with these techniques. These techniques work on carefully selected patients. I find them to be infinitely (ok that might be an exaggeration) preferable to implanted devices. I think there are a plethora of new techniques that really move the needle (or perhaps remove the needle) in the management of chronic pain syndromes. Unfortunately, most of them are not reimbursed and therefore just not really trialed in most pain practices. And honestly, in most fast moving clinical practices, we hardly have enough time to pee, let alone learn new emerging techniques. Let us be both skeptical and curious.