‘Scrambler therapy’ may finally zap away chronic pain for good

BALTIMORE — Whether we’re talking about arthritis or a lingering back injury, chronic pain can be a serious detriment to one’s quality of life. Fascinating new research, however, is putting forth a potential new way to effectively alleviate chronic pain. Scientists at Johns Hopkins Medicine say their latest work indicates a noninvasive pain treatment called scrambler therapy is capable of yielding significant relief among approximately 80 to 90 percent of chronic pain patients.

Researchers add that scrambler therapy may even be more effective than another noninvasive therapy: transcutaneous electrical nerve stimulation (TENS).

Scrambler therapy was approved by the U.S. Food and Drug Administration in 2009 and entails administering electrical stimulation through the skin using electrodes placed in areas of the body above and below the source of the chronic pain. The aim of the therapy is to capture the nerve endings and replace signals from the area experiencing pain with signals coming from adjacent areas experiencing no pain.

Consequently, this “scrambles” the pain signals being sent to the brain, explains primary study author Thomas Smith, M.D., the Harry J. Duffey Family Professor of Palliative Medicine at the Johns Hopkins Kimmel Cancer Center and a professor of oncology and medicine at the Johns Hopkins University School of Medicine.

scrambler therapy for chronic pain
Scrambler therapy used for a patient with chemotherapy-induced peripheral neuropathy. The red bursts represent areas where the patient is experiencing pain. Credit: Photo courtesy of Thomas Smith

All forms of chronic pain, and close to all nerve and neuropathic pain, stem from two factors — pain impulses originating from damaged nerves that send a constant barrage up to pain centers in the brain and the failure of inhibitory cells to block those impulses and stop them from becoming chronic.

“If you can block the ascending pain impulses and enhance the inhibitory system, you can potentially reset the brain so it doesn’t feel chronic pain nearly as badly,” Prof. Smith says in a media release. “It’s like pressing Control-Alt-Delete about a billion times.”

A number of patients tend to “get really substantial relief that can often be permanent,” Smith adds. Patients typically receive three to 12 half-hour sessions.

“Scrambler therapy is the most exciting development I have seen in years — it’s effective, it’s noninvasive, it reduces opioid use substantially and it can be permanent,” Prof. Smith concludes.

TENS therapy, meanwhile, also works by administering low-intensity electrical signals through the skin. However, TENS uses a pair of electrodes at the sites of pain. Pain relief often disappears when or soon after the electrical impulses are turned off, Prof. Smith notes. An earlier study cited in the review paper evaluated the impact of TENS across 381 randomized clinical trials, with researchers noting a non-statistically significant difference in pain relief between TENS and a placebo procedure.

The study is published in the New England Journal of Medicine.

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