Pain Patients Get ‘Substantial Relief’ from Scrambler Therapy

By Pat Anson, PNN Editor

A little-known therapy for Complex Regional Pain Syndrome (CRPS) and other painful neuropathic conditions is finally getting some attention from a prominent medical journal.

“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,´ says Thomas Smith, MD, a professor of oncology at the Johns Hopkins University School of Medicine and co-author of a review recently published in The New England Journal of Medicine.

Scrambler therapy – also known as Calmare pain therapy -- sends mild electric signals through the skin via electrodes placed near areas where chronic nerve pain is felt. Similar to transcutaneous electrical nerve stimulation (TENS), the idea is to “scramble” pain signals being sent to the brain and reduce central sensitization.

Some patients get immediate relief after a 30-minute scrambler session, but most will have to undergo a series of treatments on successive days to have a prolonged analgesic effect. Smith says many patients “get really substantial relief.”

“The duration of relief usually increases with each day of treatment, and in contrast to TENS, analgesic effects have been reported to last for weeks, months, or even years after a treatment course,” wrote Smith, who reviewed 381 clinical trials of TENS and scrambler therapy with his co-author.

“The major limitation with respect to our understanding of electroanalgesia is the small number of well-designed, large, randomized, sham-controlled clinical trials of TENS and scrambler therapy.”

In one small study, patients getting scrambler therapy had a 91% reduction in pain and reduced their use of opioids and other pain relievers by 75 percent.

“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,” Smith says. “It’s like pressing Control-Alt-Delete about a billion times.”

Scrambler therapy seems to be most effective in patients with CRPS or those who develop neuropathic pain after chemotherapy. It’s also been used to treat fibromyalgia, shingles, diabetic neuropathy and post-operative pain.

Amanda Greening was bedridden by CRPS at the young age of 20, but was able to walk again after several sessions of scrambler therapy. Amanda’s father wrote a column for PNN on her recovery. So did a local TV station:

Although scrambler therapy was approved by the FDA in 2009 for patients with chronic or neuropathic pain, the procedure is still not widely available or covered by insurance. Only one company makes the scrambler device, which costs about $65,000, and practitioners have to undergo several days of training to use it. Treatments cost about $300 per session.

Like other pain treatments, scrambler therapy doesn’t work for everyone. About 10 to 20% of  patients have no analgesic response -- a risk many would be willing to take, if it means freeing themselves from a lifetime of pain.

The Four C’s That Can Help Lower Pain Levels

By Barby Ingle, Columnist

I hear more than ever from others living with chronic pain that they “have tried everything” and nothing helps. But there are always new pain therapies being developed or improved; some real, some placebo, and some researched more than others. 

I personally don’t believe that there is any one treatment that cures or fixes anyone, but there are many that can help take the edge off the pain we are feeling. I also recognize that some options are not right for some people or contraindicated for certain conditions. There is no one-size-fits-all treatment for chronic pain.

Last month we looked at four alternative therapies that start with the letter “A” (acupressure, acupuncture, aromatherapy and art therapy). This month the spotlight is on four therapies that start with “C” – Calmare, Chinese medicine, chiropractic, and craniosacral therapy. 

Calmare Therapy

Calmare is a relatively new treatment that is becoming more popular. I have tried it myself, and while it was not a long-term useful tool for me, I do know others who have received major benefit and relief from it.

Calmare Therapy, also known as scrambler therapy, is a non-invasive, drug-free solution for neuropathy and other conditions that cause nerve damage. I think of it as TENS unit on steroids. 

Duringtreatment, small electrodes are placed on the skin, which are connected by wires to a box-like device. Electrical pulses are transmitted to the body, like little electric shocks. This can help block pain signals in some people with certain types of chronic pain.

The provider I hear about the most having success with this form of treatment is Dr. Michael Cooney, a chiropractor practicing in New Jersey who sees patients from all over country.

Cooney wrote a guest column about Calmare for PNN a few months ago, where you can learn more about the treatment and how it works.

Chinese Medicine

When people think about Chinese Medicine (CM), many just think of acupuncture, but CM is more than just one modality. It involves a broad range of traditional medicine practices which were developed in China over 2,000 years ago, including various forms of herbal medicine, massage, exercise and dietary therapy.

One of the basic tenets of CM is that the body's vital energy (chi or qi) circulates through channels called meridians, which have branches connected to bodily organs and functions.

CM is being used more and more in American pain treatment as an alternative to Western medical practices. Only six states (Alabama, Kansas, North Dakota, South Dakota, Oklahoma, and Wyoming) do not have legislation regulating the professional practice of CM. 

Be sure to tell all your healthcare providers about any complementary health approaches you use, as it is important to give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care, which is important with more than a million Americans using forms of CM. 

The prices of traditional CM vary, depending on the practitioner and the region. Usually an initial herbal consultation ranges from $30 to $60, and follow-up consultation costs around $30. A month's supply of herbs may cost $30 to $50, but it’s a good value if it helps lower your pain levels, stress and helps regulate your neuro-inflammation.

Chiropractic

Chiropractic care is a harder subject for me. I have had positives and negatives with this treatment and with different practitioners. For the most part, my insurance has covered this type of care, but for many insurance policies it is not covered at all or it only pays for a few appointments a year. 

Chirporactic sessions can range from $34 to $106, depending on where you live, how many areas of the spine the chiropractor services, and whether more extensive exams are required.

This form of alternative care typically treats mechanical disorders of the musculoskeletal system with an emphasis on the spine, although I have had chiropractors adjust my hips, feet and shoulders. 

Chiropractic care is somewhat controversial with mainstream practitioners, including some who believe it is sustained by pseudo-scientific ideas such as subluxation and "innate intelligence" that are not based on sound research. In my own reviews of studies on chiropractic manipulation, I have not found evidence that it is effective long term for chronic pain, except for treatment of back pain.

However, chiropractic care is well established in the U.S. and Canada as a form of alternative treatment. It is often combined with other manual-therapy professions, including massage therapy, osteopathy and physical therapy.

Craniosacral Therapy

Craniosacral therapy (CST) takes a whole-person approach to healing, and the inter-connections of the mind, body and spirit. Practitioners say it is an effective form of treatment for a wide range of illnesses, and encourages vitality and a sense of well-being. Because it is non-invasive, it is suitable for people of all ages, including babies, children and the elderly. 

The intent of CST treatment is to enhance the body's own self-healing and self-regulating capabilities. This is done as the practitioner gently touches areas around the brain and spinal cord, which helps improve respiration and the functioning of the central nervous system. 

CST practitioners say it can help temporarily relieve a vast number of issues, including migraines and headaches, chronic neck and back pain, stress and tension-related disorders, brain and spinal cord injuries, chronic fatigue, fibromyalgia, TMJ syndrome, scoliosis, central nervous system disorders, post-traumatic stress, orthopedic problems, depression, anxiety and grief. 

Treatment costs range between $100 and $200 per session, and patients typically attend multiple times when chronic pain issues are being addressed. Some health insurance policies will cover CST.

Do I believe that CST will take pain away? No. But do I think it is a mindfulness tool that can help temporarily. Did it work for me? No, but it was worth a try since it is non-invasive. 

Again, I am spotlighting alternative therapy ideas that can help lower or reduce chronic pain.. Typical pain patients, including myself, find that it takes a variety of treatments to get pain levels low enough to consider it significant relief. The fact that they are treatments and lifestyle changes – and not cures -- is important to remember. 

I'd like to know if you've tried these methods and if they worked or didn’t work. The more we share our ideas and experiences, the better off others in pain will be in understanding different treatment options. 

Over the next few months I will spotlight more than 70 alternative treatments. Please only try what you are comfortable with and don’t put down others who are willing to try what they are interested in. 

Barby Ingle lives with reflex sympathetic dystrophy (RSD), migralepsy and endometriosis. Barby is a chronic pain educator, patient advocate, and president of the International Pain Foundation. She is also a motivational speaker and best-selling author on pain topics. More information about Barby can be found at her website. 

The information in this column should not be considered as professional medical advice, diagnosis or treatment. It is for informational purposes only and represents the author’s opinions alone. It does not inherently express or reflect the views, opinions and/or positions of Pain News Network.

The 411 on Calmare Scrambler Therapy

By Michael Cooney, DC, Guest Columnist

As a chiropractor who treats various pain conditions caused by injury or disease, my biggest frustration is when our therapies do not achieve a successful patient outcome.

Often, “treatment-resistant” patients are forced to seek out more invasive procedures – surgeries, spinal cord stimulators, or powerful narcotics such as ketamine − where success has been uneven, but side effects can be significant.

I wasn’t comfortable recommending these “next level” neuropathic pain treatments for my patients. So my partner Dr. Robert Kelly and I spent two years looking for a non-invasive therapy that didn’t cause pain or come with added side effects.

Through a contact in Italy, we discovered Calmare scrambler therapy, which treats several types of drug and treatment-resistant pain, a big plus for our practice. After undergoing clinical training to use the machine and eventually testing it on patients, we saw results after just a few treatment sessions, in the majority of cases.

I’ll be honest, our aim in adding Calmare to our treatment offerings was designed to help our patients who were not responding to traditional pain therapies. No one was more surprised than I to experience the global interest in this alternative treatment option.

We have been performing Calmare Therapy since 2011, treating patients from coast-to-coast and as far away as Australia, the UK, South Africa and Brazil.

Today, we treat children, adults and seniors battling CRPS/RSD, fibromyalgia, neuropathy after chemotherapy treatment, and pain that develops after surgery or from diabetes. We have also treated many people with neuropathic pain after a shingles diagnosis.

How Scrambler Therapy “Talks” With the Brain

The brain’s reaction to pain can be compared to learning to play the piano or memorizing a poem. The more the body processes pain, the stronger the connections between pain nerves and the brain become.

When someone is injured, the brain sets up a process to heal the injury. For example, cells carry away dead tissue or it increases blood flow to the injured area. Eventually, the brain realizes the injury has healed, and cuts off the pain message.

But for some people, the brain never sends the all-important message: “There’s no more injury here. You can stop sending that pain signal.”

That’s where Calmare scrambler therapy comes in.

Using small electrodes (think EKG pads) judiciously placed in the region of the injury, the device sends a mild electric signal to the brain through the electrodes.

This message overrides the brain’s confused pain signal and corrects it to a “there’s no pain here” message.

We recommend a series of 10 daily scrambler treatments. But in many cases, the pain is lessened for the patient as soon as the first treatment.

The machine we use, the MC-5A Calmare device, has been tested in clinical trials at some of the most prestigious research institutions, including the Massey Cancer Institute at Virginia Commonwealth University, the Mayo Clinic, and the American Society of Clinical Oncology. Their studies reported significant reductions in pain associated with cancer treatment and other chronic pain conditions.

The Value of Alternative Medicine in Treating Neuropathy

The majority of patients we treat with scrambler therapy come to us frustrated and exhausted by the endless search for pain relief. They have often resorted to unproven surgeries, experimental procedures, or have used powerful pain medications that leave them mentally and physically debilitated by the drug’s side effects.

I encourage people with treatment-resistant neuropathy and their families to research and consider less invasive, alternative solutions to combat the effects of chronic pain. In some cases, the cost can be comparable to prescription medications and in-patient co-pays. The outcome can be life-changing.

Regardless of the pain therapy you choose, keep in mind there are treatments that do not involve narcotics, surgery or invasive procedures, which can result in more pain and discomfort.

Keep looking -- network with people who have your medical condition, conduct your own research, and reach out to doctors who understand the value of alternative therapy. Ask the provider to put you in touch with another patient who had the treatment. We enthusiastically offer this service through our Patient-2-Patient program.

There may very well be a solution out there to minimize your pain. But often, it’s up to you to discover it.

Michael J. Cooney has been a doctor of chiropractic for more than 30 years at Rutherford Allied Medical Group and Calmare Therapy NJ in Rutherford, New Jersey. He is one of six certified providers of Calmare in the U.S. Dr. Cooney can be emailed at calmarenj@gmail.com.

Pain News Network invites other readers to share their stories with us.  Send them to:  editor@PainNewsNetwork.org. 

The information in this column should not be considered as professional medical advice, diagnosis or treatment. It is for informational purposes only and represents the author’s opinions alone. It does not inherently express or reflect the views, opinions and/or positions of Pain News Network.