Hi, I'm Shubhi, one of the co-founders of Burst. This guide is for anyone managing chronic pain, back or neck pain, fibromyalgia, neuropathy, post-surgical pain, or any persistent pain condition that runs out the clock on out-of-pocket spending.

Chronic pain is the largest and broadest condition on Burst. The management toolkit is enormous: TENS units, heat and cold therapy, ergonomic, mattress toppers, recovery devices, compression, topical analgesics, supplements, and sleep tools. Most of it is FSA/HSA eligible with a Letter of Medical Necessity (LMN), and almost no one knows that without somebody telling them. So I'm telling you. I'd rather you not pay out-of-pocket for things your FSA/HSA would cover.

What FSA/HSA actually covers for chronic pain

The IRS standard is "products used to treat, mitigate, or alleviate a specific medical condition." Chronic pain (back, neck, joint, neuropathic, post-surgical), fibromyalgia, sciatica, and related conditions all qualify. So a wide range of pain management products are reimbursable, even though many of them are sold as fitness, recovery, or wellness gear.

The thing administrators want is documentation. A Letter of Medical Necessity is a short note from a licensed clinician saying the product is being used to treat your condition. With the LMN attached to your receipt, categories like ergonomic equipment, supplements, recovery devices, and sleep tools all become reimbursable.

Two facts that matter. The fee for the Burst LMN request is itself FSA/HSA eligible. And if our clinician doesn't approve your request, you get a full refund.

Categories of chronic pain products often eligible with an LMN

These are the categories I see most often in real Burst LMN requests for chronic pain. Brands are illustrative, not endorsements, not affiliate.

TENS units and electrotherapy

TENS units (iReliev, Omron, AccuMed, TechCare) are one of the most common chronic-pain LMN categories. Most TENS units are FSA/HSA eligible without an LMN, but pads, gel, and accessory kits often need supporting documentation. An LMN covers the device plus consumables for 12 months.

You can buy these at Amazon, Walgreens, CVS, Costco, or directly from the brand. The LMN works the same.

Heat therapy and cold therapy

Heating pads (Sunbeam, Pure Enrichment, MIGHTY BLISS), microwavable wraps, far-infrared heating wraps, ice packs, cryotherapy wraps, and contrast therapy tools are all FSA/HSA eligible with an LMN naming chronic pain. The category is broad and the unit cost is low, but it adds up over a year.

Saunas (in-home, infrared, traditional) and cold plunges are also eligible with an LMN. Burst has a deeper guide if you want a single-product walkthrough on those: Letter of Medical Necessity for Saunas & Cold Plunge.

Posture and ergonomic

Standing desks, ergonomic chairs (Steelcase, Herman Miller, Branch, Autonomous), lumbar supports, monitor arms, ergonomic keyboards and mice, and posture trainers (Upright Go) qualify with an LMN. The LMN should connect the specific equipment to your pain condition, which is what we write into it.

This is one of the higher-ticket categories where LMN math matters most. A $1,200 ergonomic chair plus a $400 standing desk reimbursed back at your tax-effective rate is real money.

Recovery devices

Theragun, Hyperice, foam rollers (TriggerPoint, Chirp wheels), percussion massagers, vibration plates, and stretching tools (back stretchers, decompression tables) are FSA/HSA eligible with an LMN. Recovery is one of the largest Burst LMN categories overall, and chronic pain is one of the most common conditions LMNs are written for in the category.

Compression and supports

Compression sleeves, back braces, posture braces, knee and ankle supports, and full compression garments (Bauerfeind, Tommie Copper, McDavid, Mueller) qualify with an LMN. The category overlaps with arthritis (covered in the arthritis guide) and with athletic recovery.

Topical analgesics and CBD

OTC topical pain relievers (Voltaren, Biofreeze, Aspercreme, Tiger Balm, capsaicin creams) are mostly FSA/HSA eligible without an LMN because they're OTC drugs. Topical CBD products often benefit from an LMN to clarify medical use and avoid administrator rejection.

Sleep and mattress toppers

Mattress toppers (Tempur-Pedic, Saatva, Layla), cervical pillows, contoured pillows, and adjustable bed bases qualify with an LMN where sleep is part of the chronic-pain picture (which it almost always is). Cooling sleep tools (Chilipad, BedJet, Eight Sleep accessories) qualify the same way.

Turmeric, magnesium, omega-3, and other anti-inflammatory supplements

Turmeric (curcumin), magnesium, omega-3 fish oil, MSM, boswellia, and SAM-e are commonly used for chronic pain management. None of them are FSA/HSA eligible by default. With an LMN naming chronic pain, fibromyalgia, or a related condition, they all become reimbursable. One LMN covers the supplement (any brand) for 12 months.

How Burst gets you reimbursed (3 steps)

Step 1: Request an LMN at app.getburst.com/request-lmn

Under 5 minutes. List the products. Describe your condition (chronic pain, back pain, neck pain, fibromyalgia, neuropathy, post-surgical pain). Submit.

Step 2: A Burst clinician reviews and signs

Most LMN requests come back in under 24 hours. A licensed clinician on our network reviews. If your situation qualifies, you get the signed LMN. If it doesn't, you get a full refund.

Step 3: File the LMN with your administrator

Log into your administrator (HealthEquity, Optum Financial, WEX, Inspira, Lively). Upload the LMN plus your receipt. Submit. Reimbursement usually lands in a week or two.

The Burst team wrote a step-by-step walkthrough for the most common administrators: How to file your LMN for reimbursement.

We don't care which brand or store you buy from. The LMN covers the product, not the storefront.

One LMN, 12 months, any store

A single LMN from Burst covers that product for 12 months. Approved once, you can keep buying the same Theragun, the same magnesium, the same heating pad, the same ergonomic chair components, all year, and keep using your FSA/HSA for them.

People I talk to who manage chronic pain tend to shop across many places: Amazon for the topicals and supplements, Costco for the heating pads, the brand site for the chair or device, Best Buy for the recovery tools. The LMN doesn't care where you bought. It cares about the product and the condition.

FAQ

Is a TENS unit FSA eligible for chronic pain?
Yes. Most TENS units are FSA/HSA eligible without an LMN. Pads and accessories sometimes get flagged, and an LMN covers those for 12 months along with the device.

Are mattress toppers FSA eligible?
Yes, with a Letter of Medical Necessity that connects the mattress topper to chronic pain, fibromyalgia, or a related condition. Without an LMN, mattress toppers are usually rejected as a comfort or sleep product.

Is a heating pad FSA eligible?
Standard heating pads are usually FSA/HSA eligible without an LMN. Specialty heat therapy products (paraffin baths, infrared heating wraps, sauna blankets) often need an LMN, which we write to cover all of them.

Are turmeric and magnesium FSA eligible?
Supplements are FSA/HSA eligible only with an LMN. With an LMN naming chronic pain or a related condition, turmeric, magnesium, omega-3, MSM, and boswellia all become reimbursable.

Is an ergonomic chair FSA eligible?
Yes, with an LMN. Steelcase, Herman Miller, Branch, Autonomous, and similar chairs are reimbursable when the LMN connects them to chronic back, neck, or hip pain. Same rule for standing desks and other ergonomic equipment.

Are saunas and cold plunges FSA eligible?
Yes, with an LMN. The deeper walkthrough is here: Letter of Medical Necessity for Saunas & Cold Plunge.

Can I use my FSA card directly, or do I have to file for reimbursement?
Either works. Most chronic-pain LMN purchases (supplements, ergonomic, recovery tools, mattress toppers) are pay-out-of-pocket and file-for-reimbursement. The LMN attached to your receipt is what makes it reimbursable.

What if my administrator rejects the claim?
Reply with the LMN PDF and your receipt. If they still reject, email support@getburst.com and we'll help you appeal.

Is the LMN fee itself FSA/HSA eligible?
Yes.

Stop paying out-of-pocket for chronic pain management

If you're managing chronic pain and shopping across multiple brands or stores for things that help, I'd rather you stop paying out-of-pocket for purchases your FSA/HSA would cover. Get an LMN from Burst in under 5 minutes. If our clinician doesn't approve it, you get a full refund.

Request my LMN →

If you're not sure whether something specific qualifies, hit reply on any Burst email or write to support@getburst.com. I read every email myself. I'd rather sanity-check for you up front than have you guess.

Thanks,
Shubhi
Co-founder at Burst