Curr Opin Anaesthesiol 2021 Dec 1;34(6):768-773. PMID: 34653073DOI: 10.1097/ACO.0000000000001073
Scrambler therapy for noncancer neuropathic pain: a focused review
Salahadin Abdi 1 , Matthew Chung 2 , Giuseppe Marineo 3
Affiliations
- 1 Division of Anesthesia, Critical Care and Pain Medicine, Department of Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
- 2 Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
- 3 Delta Research & Development, University of Rome Tor Vergata, Rome, Italy.
Abstract
Purpose of review: Therapeutic methods for neuropathic are limited; available drugs can be inadequate or have adverse effects that compromise quality of life. Interest has grown in alternatives to pharmacologic therapy for neuropathic pain. We present a focused review of the literature about the relatively novel noninvasive, nonpharmacologic electrocutaneous nerve stimulation technique called scrambler therapy for treating noncancer neuropathic pain.
Recent findings: Neuromodulation techniques targeting peripheral sites have changed rapidly in recent years. Several clinical studies have demonstrated the analgesic effect of scrambler therapy after 10 sessions of treatment for various types of pain. Although scrambler therapy was originally used for cancer pain, its indications have broadened to postoperative pain, chemotherapy-induced peripheral neuropathy, postherpetic neuralgia, low back pain, diabetic neuropathy, complex regional pain syndrome and central pain syndrome. That said, some of the studies are controversial owing to their small sample size, lack of appropriate scrambler therapy protocol and possible lack of experience of the operators.
Summary: We present the historical perspective, mechanism of action and trial outcomes of scrambler therapy, representing an avenue for managing neuropathic pain without drugs. Well designed phase II/III clinical trials must be conducted to confirm the positive findings reported using scrambler therapy technology. If validated, scrambler therapy could be a game changer.
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