Frequently Asked Questions

Quell device

About the Quell device

How is Quell different from other TENS devices?

Quell is designed specifically to provide widespread relief from chronic pain. Quell’s clinically proven intensive nerve stimulation technology is 5x more powerful than other leading over-the-counter pain relief devices. Quell’s OptiTherapy® customizes and automatically adjusts therapy so that you receive optimal pain relief.

Is it covered by my health insurance?

As Quell is FDA cleared for sale without a prescription, most insurance companies will not cover the cost directly, but you may apply the cost toward your Flexible Spending Account (FSA) or Health Savings Account (HSA).

Do I need a Quell device for each leg?

No. Quell’s prescription strength therapy stimulates the sensory nerves in your leg, with the sensory nerve signal traveling up to your brain. This signal in the brain releases endogenous opioids into the spine, which provide widespread relief from chronic pain. Therefore, Quell provides widespread pain relief.

Calibration

When do I need to calibrate my device?

You must calibrate the device before the first use. You may repeat calibration if pain relief has diminished.

Do I need to calibrate the device before each therapy session?

No. Once your device is calibrated, you do not need to calibrate it again unless pain relief has lessened.

Do I need to recalibrate when I switch legs?

No.

How can I be sure that I have calibrated correctly?

If you have calibrated correctly, the stimulation during therapy should feel strong but comfortable. The stimulation intensity ramps up during the first 2 minutes of each therapy session, so it may feel light at first. If it feels too strong or if you do not feel like you are getting relief, you may want to either adjust the intensity or repeat the calibration process.

Using Quell

Does it matter if I put the device on upside down?

Technically, the device will still work, but the optimal placement is on the calf, one to two inches below the knee, with the lights facing up so you can see them.

What does the stimulation feel like?

During therapy, the stimulation feels like a strong but comfortable tingling sensation. You are in control and can adjust the intensity as needed.

How long is a therapy session?

60 minutes. You may stop it manually at any time by pushing the button on the device four times quickly. You can also start and stop therapy using the Quell app.

How often can I use the device?

You may use it as often as needed for pain relief (even 24 hours a day). We recommend using your Quell for at least two to three full hour therapy sessions per day for the first several weeks to ensure you give Quell enough time to work.

How quickly will I get pain relief?

While it can vary, you may experience pain relief as early as 15 minutes after the start of a therapy session. However, it may take several weeks to realize the pain relief benefits of Quell.

Does the pain relief last beyond the end of a therapy session?

Yes. Pain relief may last up to an additional 60 minutes.

Can I use it with pain medication?

Yes, Quell is safe to use with your pain medication. However, we recommend letting your doctor know you are using Quell so he or she can develop the right pain management program for you.

Can I use Quell while I’m pregnant?

Quell can be used by pregnant women as long as it is placed as instructed on the upper calf. If you have any questions, please consult your doctor.

Who should not use Quell?

Quell is contraindicated if you have a cardiac pacemaker, implanted defibrillator, or other implanted metallic or electronic device. If any of these apply to you, please talk with your doctor before using the device.

Can I use Quell for headaches or migraines?

Quell is not likely to treat headaches or migraines successfully, as they occur in an area of the brain other than the area that Quell targets to treat chronic pain.

Are there side effects?

No, but some people may experience mild skin irritation under the electrodes after prolonged use.

Using Quell while sleeping

Can I use it while sleeping?

Yes, you may use Quell to provide pain relief while you fall asleep and throughout the night.

How do I ensure the device doesn’t wake me up while I’m asleep?

Quell offers 3 sleep mode variations, which can be controlled from the Quell app, so you can personalize your therapy.

What does Quell do while I am sleeping?

It starts 60 minute therapy sessions every other hour throughout the night, just as it does during the day. You can choose whether you want the level of stimulation to be the same as during the day or a reduced level of stimulation at night. If you need more information, please consult Chapter 6, Overnight Therapy, in the User Manual.

What if I only want a single 60 minute therapy session when going to sleep?

You can set the sleep setting to “Bedtime Only.” If you need more information, please consult Chapter 6, Overnight Therapy, in the User Manual.

What should I do before going to sleep with my Quell on?

Make sure the device is securely and comfortably placed around your leg. Then start the first therapy session by briefly clicking the button.

Electrodes

Does it matter which way I attach the electrode? Is it possible to attach it upside down?

You can attach the electrode in either orientation. The important point is to have both snaps connected.

How often do I need to change the electrode?

Electrodes may last up to 2 weeks.

How do I know when I need to replace the electrode?

If the electrode is no longer making good contact with your skin, you may want to change the electrode. You can continue to use the electrode even if the gel pad has started to peel away, as long as all four electrode gel pads make good skin contact and therapy sensations remain comfortable.

Can I use other types of gel to extend electrode life?

We do not recommend the use of supplemental gels on the Quell electrode, as they may adversely impact performance. The Quell electrode hydrogel was designed specifically to work with the Quell system and can last up to 2 weeks.

Can I use a different manufacturer’s electrode?

The Quell electrode is the only electrode cleared by the FDA for use with the Quell device. The Quell electrode was designed to ensure optimal performance and the highest level of safety.

What does it mean when the therapy stops and the light is blinking orange continuously?

A blinking orange light typically indicates poor contact between the electrode and the skin. This may occur because the device is not securely placed on the leg or has unsnapped, or because the electrode is dry. Check that the electrode is snapped into the back of the device, the electrode is in complete contact with the skin, and the band is attached snugly (but not too tightly) on the leg. Start therapy again. If the problem persists, you can either try replacing the electrode or call Customer Care at 1.800.204.6577.

What are the materials or ingredients in the electrode?

The hydrogel consists primarily of water, salt glycerin and a dimethylacrylamide-based polymer matrix. The hydrogel does not contain latex, BPA or phthalates.

About the app

Do I need the iOS or Android app to operate Quell?

No. Quell will function without the app. However the app will allow you to calibrate your device without having to touch the button, start and stop, control and customize therapy from your smartphone.

Is there any cost for the app?

No, the app may be downloaded for free from the Apple or Android app stores.

Charging the battery

How often will I need to charge the battery?

The battery will typically last over 30 hours (or 4-7 days) of therapy. Battery life depends on your therapy intensity and frequency of use.

How long does it take to recharge the battery?

Fully recharging the battery will take 2-3 hours when connecting to a charging adaptor plugged into a wall outlet. After charging is complete, all the lights on the device will go out.

What if I see a flashing orange light when I plug my device in to charge it?

If the orange light continues to blink after the device has been plugged into the adaptor and an outlet, there is a charging issue. Please call Customer Care at 800.204.6577.

Therapy Insights

What is the right number of daily therapy sessions?

Everyone has different needs. The average Quell user runs about 4 therapy sessions per day. The 25% most intensive users run about 7 therapy sessions per day. Feedback from users suggests that people who use Quell for at least several sessions each day on a regular basis get the best results.

What is the best utilization level?

Everyone has different needs, however regular use of Quell may lead to the most effective and consistent pain relief.  A utilization level below 50% may suggest that Quell use is too infrequent.  Many Quell users have a utilization level above 75%.

Sleep monitoring

How does Quell monitor my sleep?

The device has an accelerometer and algorithms that decode your movements and body position, from which sleep quantity, quality, and other characteristics are determined.

How does Quell sleep monitoring compare to other wearable devices?

Most wearable devices are located on the wrist, whereas Quell is placed on the leg. As a result, Quell acquires unique information about body movements and position that provides novel insights about your sleep.

How does Quell know when I got to sleep?

Quell has algorithms that determine when you are in bed and trying to sleep. If you find that Quell is overestimating your Time Asleep, you can indicate when you are about to go to sleep in the “Lights Out” section of the Settings screen.

What can I do if Quell overestimates time in bed?

Reading in bed or watching TV with your legs elevated may be treated as “in bed” by Quell. You can indicate that you are about to go to sleep in the “Lights Out” section of the Settings screen.

Why does Quell occasionally underestimate how much I sleep?

If you tend to move a lot while sleeping, it may be difficult for Quell to reliably determine when you fall asleep. You may disable this feature, called Automatic Sleep Onset, in the “Lights Out” section of the Settings screen. If you do this, you will also need to indicate when you are about to go to sleep.

Why is the amount of time I spend in bed important?

If you have difficulty sleeping and your time in bed is much longer than your Time Asleep, you might consider waiting to get into bed until you are ready for sleep.

How much sleep do I need?

According to the American Academy of Sleep Medicine (AASM), adults should sleep 7 or more hours per night on a regular basis to promote optimal health. Consistently sleeping less than 7 hours per night is associated with increased pain and poorer health, including weight gain, diabetes, high blood pressure and depression.1

How does sleep amount impact chronic pain?

According to the American Academy of Sleep Medicine (AASM), sleeping less than 6 hours leads to increased pain. Sleeping for 7 or more hours is consistently associated with reduced pain.2

How can I improve the amount and quality of my sleep?

Please visit this website for healthy sleeping tips: Mayo Clinic: 7 steps to better sleep.

What is a good Time Awake number?

For good quality sleep, your Time Awake should typically be less than about 10% of your Time Asleep.  The app will indicate if your Time Awake is high.  This information is not diagnostic, but may help you identify trends that you can discuss with your doctor.

Sleep positions

What is a typical number of position changes while sleeping?

Most adults change body position 5 to 20 times a night.3  The app will indicate if the number of times you change body position is low or high. This information is not diagnostic, but may help you identify trends that you can discuss with your doctor.

What does it mean if I frequently change body position?

A high number of Position Changes may indicate that you are uncomfortable while sleeping. One possible cause is pain.

I only change my body position a few times a night; should I be concerned?

There are various reasons for a low number of Position Changes while sleeping. If you have concerns about your sleep, you should discuss them with your doctor.

How many repetitive leg movements should I expect?

Adults typically have less than 50 repetitive leg movements a night.4  The app will indicate if your repetitive leg movements are high. This information is not diagnostic, but may help you identify trends that you can discuss with your doctor.

Why do I have high numbers of leg movements?

There are several reasons for a high number of repetitive leg movements while sleeping. Some people with chronic pain at night tend to have poor sleep and frequent repetitive leg movements. If you have concerns about your sleep, you should discuss them with your doctor.

Why is the app not showing "sleep on back" or “sleep on L, R" percentages?

You need to start Sleep Position Tracking in the Settings screen every night you want your sleep position analyzed.

Do I need to start sleep position tracking every night?

Only if you want sleep position information every night.

Does sleep position tracking depend on which leg is the device is placed on?

No, you may place the device on either leg.

Is it better to review my sleep position results over time?

Yes, using the week or month period in the Sleep Tracking screen will provide the most relevant assessment of your sleep position.

Will sleeping on my back increase my snoring?

Back sleeping may increase snoring. Side sleeping is recommended for people who snore or have other sleep related breathing issues. There are a number of recommended ways to decrease back sleeping. Please visit WebMD: 7 Easy Fixes for Snoring.

Does sleep position impact low back pain?

There are a number of ways to minimize back pain, depending on your sleep position. Please visit Mayo Clinic: Sleeping positions that reduce back pain.

Activity Insights

How does Quell monitor my activity?

The device has an accelerometer and algorithms that decode your leg movements from which the number of steps you take, the amount you walk, and characteristics of your gait are determined.

How does Quell activity monitoring compare to other wearable devices?

Most wearable devices are worn on the wrist, whereas Quell is placed on the leg. As a result, Quell acquires detailed information about your stride; from which accurate step counts and gait measurements are obtained.

How does Quell assess my activity level?

Quell measures how many steps you take and how much you walk, while wearing the device.

Can Quell track jogging and running?

Quell is optimized to track your walking.  However, it will also accurately track jogging.   It may not effectively track running depending on the speed.

How does Quell activity level tracking help with my chronic pain?

An increased level of activity is one of the best ways to reduce your pain, lessen its impact on your sleep and mood, and improve your overall health and reduce your risk of chronic diseases.  Most treatment guidelines advise those with chronic pain to remain active and discourage a sedentary lifestyle.

How much activity do I need?

Regular physical activity helps improve your overall health and fitness, and reduces your risk for many chronic diseases.  According to the Centers for Disease Control and Prevention (CDC), adults need at least 2.5 hours of moderate-intensity aerobic activity, such as brisk walking, every week.  The American Heart Association (AHA) recommends a daily target of 10,000 steps.

What is gait?

Gait is the manner in which you walk.

How does Quell assess my gait?

Quell measures two quantitative features of your gait, its cadence and variability.  The app will show your average cadence and lowest variability for every day you wear your device.

What is gait cadence?

Cadence is the number of steps you take in 1 minute.  Most people have a cadence over 80-90 steps per minute when walking.  The cadence of running may reach 180 steps per minute.  Quell is optimized for measurement of walking cadence.

What does it mean if my cadence is slow?

There are various reasons for a slow cadence, one of which is chronic pain.   If your cadence is consistently well below 80 steps per minute you should discuss with your doctor.

What is gait variability?

Gait variability can be defined in various ways.  Quell uses stride time variability, which is the fluctuation in the time between successive placements of the same foot when you walk.  Gait variability is usually expressed as a percentage.  Healthy gait is typically below about 5 – 6%.

How does chronic pain affect gait variability?

It may increase gait variability.

Are there medical conditions that impact variability?

There are a number of medical conditions that may increase gait variability.  Certain medications may also impact your gait variability.

What other factors influence gait variability?

Gait variability may increase if you walk much slower or faster than your comfortable walking speed.  For example, walking your dog or walking on a crowded side-walk will often increase your gait variability.  Walking on uneven terrain such as sand, while hiking, and stairs can also increase your gait variability.

How can I get the most accurate assessment of my true gait?

Walk for a few minutes at your comfortable walking speed on a flat surface such as a sidewalk or paved road.

What does it mean if my gait variability is high?

Healthy gait has low variability. High variability increases the risk of falling, and may indicate other medical conditions.  If you are concerned about your gait variability, you should discuss with your doctor.

Pain Insights

Why should I rate my pain?

Effective pain management requires an understanding of your underlying pain patterns.  If you track your pain, you and your doctor may be able to identify triggers that exacerbate your pain.

How often should I rate my pain?

Your pain log will be most useful if you rate your pain level and pain interference daily or at least 4-5 times per week.

Do I need to complete all four pain ratings every time?

No, you can choose which ratings you complete.  However, your pain log will be most informative if you complete all four ratings on a regular basis.

Should I try to rate my pain at the same time of day?

Yes, it is best to rate your pain level and pain interference about the same time each day.  Some people chose to rate pain interference with sleep in the morning, and pain level and interference with activity and mood in the evening.

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