An Exploratory Study on the Effectiveness of Scrambler Therapy in Patients with Cancer Pain: a pilot study

Abstract

Introduction Scrambler therapy is a novel approach for pain control that uses EKG-like pads, which are applied above and below the site of pain. It is a method to control pain that attempts to relieve pain by providing non-pain information via cutaneous nerves to block the effect of pain information. So it is necessary to evaluate effects of scrambler therapy to widen clinical range of management. We performed an exploratory study on the effectiveness of scrambler therapy in patients with various cancer pain syndromes. Material and method Eleven cancer patients diagnosed with cancer-related metastatic bone pain (n = 5), chemotherapy-induced peripheral neuropathy (n = 4), postherpetic neuralgia (n = 1) and postradiotherapy pain (n = 1) were analyzed in the study. Scrambler therapy was applied for 40 minutes (one treatment per day) during the ten consecutive days to these patients. The primary endpoint was an 11-point numerical rating scale (NRS) pain score during the therapy and at one month after the procedure. The secondary endpoint was Likert scale, satisfaction scale, change of opioid consumption dose and brief pain inventory (BPI). Result NRS are significantly decreased in the patients with cancer pain syndromes during the scrambler therapy (p-value=0.009) and pain relief was sustained at least two weeks after the 10th treatment. Even though regular opioid dose was not changed remarkably, the consumption of rescue opioid was reduced significantly (p-value = 0.01) than initial consumption dose of rescue opioid. All components of BPI except normal work (p-value = 0.066) are improved than before treatment. Conclusion Scrambler therapy was helpful to relieve cancer-related pain. We assessed NRS, Likert scales, satisfaction scales, BPI and checked dose of opioid consumption. Consequently breakthrough pain was relieved than background pain more. Breakthrough pain relief made quality of life improve in cancer pain syndromes. It was revealed through BPI which several components associated with quality of life were improved. However, the mechanism of pain scrambler therapy was unknown yet. Further evaluations about scrambler therapy will be needed to explain exact mechanism. Also, a small number of patients and no control group were limitations of this study.