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Scrambler Therapy Could Provide Long-Term Relief From Chronic Pain

A woman in an orange top holds her leg in pain.
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A new paper penned by pain experts provides compelling evidence for the effectiveness of scrambler therapy as a treatment for chronic pain. The paper suggests that the noninvasive procedure can offer substantial relief to roughly 8090% of patients, potentially outperforming another well-known therapy.

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The paper, published online in The New England Journal of Medicine on July 13, compares scrambler therapy with transcutaneous electrical nerve stimulation (TENS) and concludes that scrambler therapy may be more beneficial for chronic pain sufferers.

Scrambler therapy explained

Approved by the US Food and Drug Administration in 2009, scrambler therapy involves the application of electrical stimulation to the skin via electrodes. These electrodes are strategically placed both above and below areas experiencing chronic pain. The aim of the therapy is to target the nerve endings in these areas, mixing up signals from nerves reporting pain with those from adjoining pain-free areas. By “scrambling” these inputs, pain can be reduced.

The study’s lead author, Dr. Thomas Smith, from the Harry J. Duffey Family Professor of Palliative Medicine at the Johns Hopkins Kimmel Cancer Center, explains that chronic pain usually arises from two sources: the ongoing impulses from damaged nerves and the failure of inhibitory cells to impede these impulses.

“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.”

Patients treated with scrambler therapy typically undergo up to 12 half-hour sessions. Many reportedly achieve lasting, possibly permanent relief.

Smith, a seasoned physician in chronic pain treatment, describes scrambler therapy as the “most exciting development” he has witnessed in years. He praises its effectiveness, noninvasive nature, impact on opioid use and duration of effect.

Comparison with TENS therapy

TENS therapy, in comparison, also uses electrical signals applied directly to the pain sites. Unlike scrambler therapy, the relief often dissipates when the electrical impulses are ended. The review paper cites a study encompassing 381 randomized clinical trials that found no statistically significant difference in pain relief between TENS and a placebo stimulation procedure.

Reference: Smith TJ, Wang EJ, Loprinzi CL. Cutaneous Electroanalgesia for Relief of Chronic and Neuropathic Pain. NEJM. 2023;389(2):158-164. doi:10.1056/NEJMra2110098

This article is a rework of a press release issued by Johns Hopkins University. Material has been edited for length and content.