Scrambler Therapy for the management of chronic pain

Abstract

Purpose Chronic pain is a widespread and debilitating condition, encountered by physicians in a variety of practice settings. Although many pharmacologic and behavioral strategies exist for the management of this condition, treatment is often unsatisfactory. Scrambler Therapy is a novel, non-invasive pain modifying technique that utilizes transcutaneous electrical stimulation of pain fibers with the intent of re-organizing maladaptive signaling pathways. This review was conducted to further evaluate what is known regarding the mechanisms and mechanics of Scrambler Therapy and to investigate the preliminary data pertaining to the efficacy of this treatment modality. Methods The PubMed/Medline, SCOPUS, EMBASE, and Google Scholar databases were searched for all articles published on Scrambler Therapy prior to November 2015. All case studies and clinical trials were evaluated and reported in a descriptive manner. Results To date, 20 reports, of varying scientific quality, have been published regarding this device; all but one small study, published only as an abstract, provided results that appear positive. Conclusion The positive findings from preliminary studies with Scrambler Therapy support that this device provides benefit for patients with refractory pain syndromes. Larger, randomized studies are required to further evaluate the efficacy of this approach.

Case Report: Scrambler Therapy for Treatment-Resistant Central Neuropathic Pain in a Patient with Transverse Myelitis

“…The patient further recounted that this treatment was tolerable, and no safety concerns have emerged in our patient or others treated with Scrambler. 7 Our patient's re-emergence of pain at approximately 90 days, mirrors data from 9 Scrambler use in peripheral neuropathic pain conditions. Observational research suggests that patients who receive subsequent treatments continue to respond to additional treatments, often with fewer treatments needed over time.…”

TFOS DEWS II pain and sensation report

“…For patients who report pain in multiple body parts as well as the eye, management of or referral for neuropathic pain interventions should be evoked such as neuropathic pain therapy [408,419], a diet rich in anti-oxidants [525,526], s ystemic pharmacological agents traditionally used to manage pain (such as anticonvulsants, tricyclic antidepressants, opioids) [486,527,528,530] topical analgesia [531], neuromodulators (such as diclofenac, gabapentin and pregabalin) [528,532–540], GABAergics in late stage pain [529], and using stimulation therapies and psychological treatments (including exercise, acupuncture, “scrambler” or peripheral stimulation therapy, transcranial magnetic stimulation, transcranial direct current stimulation and cognitive behavior therapy) [541–543]. These have mostly not been investigated specifically for ocular neuropathic pain, but there is evidence of effectiveness in neuropathic pain and/or chronic pain syndromes, so further research is warranted.…”

Future cancer research priorities in the USA: a Lancet Oncology Commission

“…Unfortunately, this intervention has not been extensively tested and not widely available. 192 Drug–disease or drug–drug interactions (in the case of traditional pharmacological approaches) warrant strengthened efforts to identify new drugs (or non-pharmacological approaches) to effectively mitigate common constellations of symptoms emanating from cancer treatment or the cancer, 193 and to develop mechanistic and predictive models for treatment of adverse effects and symptom risk, taking into account genomics, age, function, and comorbidities.…”