Scrambler therapy is a noninvasive approach that uses surface electrostimulation on dermatomes to "scramble" the transmission of pain messages to the brain. Scrambler therapy has been examined in patients with cancer for its effect on neuropathic pain and neuropathy symptoms.
Majithia, N., Smith, T.J., Coyne, P.J., Abdi, S., Pachman, D.R., Lachance, D., . . . O’Neill, C. (2016). Scrambler therapy for the management of chronic pain. Supportive Care in Cancer, 24, 2807–2814.
STUDY PURPOSE: To evaluate what is known about mechanisms of scramble therapy and investigate preliminary evidence regarding efficacy
TYPE OF STUDY: General review/semi-systematic review
PHASE OF CARE: Not specified or not applicable
Most reports showed positive results for pain reduction for various pain syndromes. One double-blind, randomized trial showed no difference between controls and those receiving scrambler therapy for chemotherapy-related peripheral neuropathy.
Scramble therapy may have benefit for management of chronic pain and symptoms of peripheral neuropathy; however, current evidence is limited and weak.
Scrambler therapy, a neuromodulator approach to pain relief, may have some benefit in the management of chronic pain and peripheral neuropathy; however, current evidence is limited, and study designs have high risk of bias. Given the promising findings with scrambler therapy, additional well-designed research is warranted.
Pachman, D.R., Weisbrod, B.L., Seisler, D.K., Barton, D.L., Fee-Schroeder, K.C., Smith, T.J., . . . Loprinzi, C.L. (2015). Pilot evaluation of Scrambler therapy for the treatment of chemotherapy-induced peripheral neuropathy. Supportive Care in Cancer, 23, 943–951.
To determine the effectiveness of Scrambler therapy in patients with chemotherapy-induced peripheral neuropathy (CIPN)
Scrambler therapy involves the use of low-dose electrical stimulation delivered through electrodes placed around patient-reported painful areas. Five sets of electrodes can be placed around a painful area at one time. The goal of this study was to replace pain with no pain and/or lessening of symptoms. Patients were treated daily for up to 10 days.
PHASE OF CARE: Mutliple phases of care
Prospective, open-label trial
Measurements included numerical analog scales from 0–10 that were part of a neuropathy questionnaire, a global impression of change questionnaire, and the Rydel-Seiffer Tuning Fork to evaluate patient vibratory sense.
Pain scores decreased 53% from baseline to day 10. Numbness decreased 37%, and tingling decreased 44%. Increased quality of life was reported during treatment as well as during the 10-week follow-up period. All of these changes were significant (p < 0.0002). The vibration perception scores measured with the Rydel-Seiffer Tuning Fork also improved.
Although Scrambler therapy demonstrated positive effects in this trial, a large randomized, controlled trial is needed to confirm its efficacy in CIPN. Special training and experienced personnel need to be in place for someone to deliver this therapy. Practicality and cost need to be factored in for this type of intervention.
A large, randomized study is needed for future research. Scrambler therapy is not a very practical treatment, and cost of the treatment was not discussed. Also, specific training is needed to administer it. Currently, insufficient evidence recommends its use.