January 26, 2016 by Beth Gilbert, Clinical Pain Advisor
Calmare therapy (CT) may be an effective option for treating cancer-related neuropathic pain (CNP), according to a pilot study published in issue of theEuropean Journal of Oncology Nursing.1
Also known as scrambler therapy, the novel, noninvasive approach consists of applying surface electrodes around the surface of painful areas to ‘scramble’ afferent pain signals and replace them with synthetic ‘non-pain’ information.
The open-label study included 20 patients with the 3 most common causes of CNP: chemotherapy-induced peripheral neuropathy (CIPN; n=6), metastatic bone pain (n=7), and post-surgical neuropathic pain (n=7).
CT was applied for 40 minutes each day for 10 consecutive days; up to 2 days could be skipped at weekends. The primary endpoint was pain score, as evaluated on an 11-point numerical rating scale (NRS). Other measures included the Brief Pain Inventory (BPI) and opioid consumption.
Results at 1 month showed that CT yielded a 50% decrease in mean pain scores from baseline (3.7 vs 7.4, P < .001); 15 patients (75%) experienced a 30% or greater decrease in pain (30% – 50%, 45%; >50%, 30%). Pain relief was significant across pain subtypes, including CIPN (3.1 vs 6.1, P =.027), metastatic bone pain (3.1 vs 7.4, P = .018), and post-surgical neuropathic pain (5.2 vs 8.5, P = .028).
The approach was also associated with significant improvements in all 7 domains of the Brief Pain Inventory (BPI, P <.001 to P = .016)), and decreased use of opioid rescue therapy (P = .050). Half the patients treated expressed slight to moderate satisfaction with CT, while the other half remained neutral.
“The most important thing to note is that, without adding medications or increasing doses of existing prescriptions, this treatment provided patients with clinically significant relief, as 75% of patients experienced a 30% or greater improvement in pain,” Bob Twillman, PhD, executive director of the American Academy of Pain Management, told Clinical Pain Advisor.
Further Research Needed
The pilot study is primarily limited by its small sample size and open-label nature. Although larger studies can be conducted, the open-label aspect is not likely to be amenable to manipulation, Dr Twillman said.
“It would be really nice to have a double-blind, placebo-controlled, randomized clinical trial, but the nature of [CT] doesn’t really lend itself to even a single-blind trial. Thus, we will need to see a series of replications using a similar design. At some point, it might be possible to examine whether using Calmare therapy could enable patients to taper doses of opioids and other medications previously used to treat their pain,” Dr Twillman said.
According to study author Jee Youn Moon, MD, PhD, from the department of anesthesiology and pain medicine at Seoul National University Hospital College of Medicine in the Republic of Korea, other potential study limitations include barriers to CT access and placebo effect.
“Even though we included cancer patients who had life expectancy of greater than 3 months and tolerable health conditions, it might have been difficult for debilitated cancer patients to visit the outpatient department to obtain Calmare therapy for consecutive days, 2 weeks at a time,” Dr Moon pointed out.
“In addition, our study was not controlled for a possible placebo effect, although the pain reductionwas greater than that seen in previous placebo-controlled trials of cancer-related pain or chronic non-cancer pain,” he added.
Dr Moon also noted the need to investigate the effect of CT on specific symptoms, such as allodynia, hyperalgesia, tingling, and numbness. Studies are currently in development to evaluate the duration of CT efficacy in patients with various types of pain, and to determine its mechanism of action.
Multimodal Approach Remains Best
Similar devices, such as transcutaneous electrical nerve stimulation (TENS) units, have proven relatively ineffective in the treatment of pain conditions, Edward Michna, MD, anesthesiologist and director of pain clinical trials at Brigham and Women’s Hospital, and associate professor of anesthesia at Harvard Medical School in Boston Massachusetts, told Clinical Pain Advisor.
There is a possibility that Calmare therapy may decrease pain but not completely eliminate it. The best approach will continue to be a multimodal combination of medications, psychotherapy, and adjuvant therapies, Dr Michna added.
Although TENS was recently dropped from Medicare coverage, likely due to limited efficacy, this study suggests that there may be very good reasons to revisit that decision in certain circumstances, Dr Twillman pointed out.
“If this therapy is proven effective and covered by insurance companies, it could potentially revolutionize the treatment of cancer-related neuropathic pain. It could obviate the need to use opioids and other medications, with their potentially severe side effects, to treat this type of pain,” Dr Twillman concluded.
Lee SC, Park KS, Moon JY, et al. An exploratory study on the effectiveness of “Calmare therapy” in patients with cancer-related neuropathic pain: A pilot study. European Journal of Oncology Nursing. 2016;21:1-7. http://dx.doi.org/10.1016/j.ejon.2015.12.001.February 1, 2016
Another pilot study has confirmed that “scrambler” therapy is an effective, noninvasive treatment for various types of cancer-related neuropathic pain, including chemotherapy-induced peripheral neuropathy (CIPN). And as in several previous small trials, no adverse events were reported.
In scrambler therapy, electrocardiographic-like pads are placed around the area of pain. The device then synthesizes different types of nerve action potentials that deliver nonpain information through cutaneous nerves to the pain site. It is thought that scrambling afferent pain signals and replacing them with nonpain signals induces pain relief.
One such device, from Calmare Therapeutics, is cleared for use in both the United States and Europe. The Calmare device was named in honor of the Italian inventors, according to the manufacturer; in Italian, calmare means “to soothe or ease.”
Latest Study From South Korea
The latest study of the technique, by Sang Chul Lee, MD, PhD, from the National University Hospital College of Medicine in Seoul, South Korea, and colleagues, was published online December 28 in the European Journal of Oncology Nursing.
Dr Lee’s team reports that using the Calmare device to administer scrambler therapy for 10 consecutive days significantly reduced pain scores in patients with various types of cancer-related neuropathic pain, including CIPN. The therapy also improved quality of life and reduced the use of rescue opioids, although patients remained on background opioid pain management.
“Our results reinforce the idea that Calmare therapy is an effective tool for managing CIPN when it is refractory to standard medication, such as anticonvulsants, antidepressants, and/or opioid analgesics,” Dr Lee and his colleagues write.
The therapy “might be another treatment option to help manage intractable cancer-related neuropathic pain, including bone metastatic pain and postsurgical neuropathic pain,” they add.
“Prospective studies are recommended to confirm our findings and ascertain which additional cancer-related neuropathic pain can show a positive response to Calmare therapy,” they note.
The study was an open-label, single-group exploratory study designed to evaluate the effectiveness of scrambler therapy in various types of cancer-related neuropathic pain.
Patients were eligible for the study if they had cancer- or surgical-related neuropathic pain or mixed pain. Pain was classified as CIPN caused by metastatic bone lesions or postsurgical CIPN neuropathic pain.
All patients underwent baseline screening before therapy, and were then treated with 40 minutes of scrambler therapy each day for 10 consecutive days. Treatment response was assessed after 1 month.
The 20 patients who completed the 10-day course of scrambler therapy were evaluated at follow-up.
Regardless of the type of neuropathic pain being treated, scores on the 11-point Numerical Rating Scale (NRS) decreased significantly from baseline to 1-month follow-up (P < .001).
At follow-up, six patients reported a decrease in pain of at least 50%, nine reported a decrease of 30% to 50%, and five reported a decrease of less than 30%. So 15 patients (75%) experienced a reduction in pain of at least 30% pain, whereas no patient experienced an increase in pain, Dr Lee reported.
After the first week of treatment, NRS pain scores were significantly better (P < .001), and responses were sustained 2 weeks after the end of treatment.
Brief Pain Inventory scores were also significantly better at follow-up, and half the patients who finished the treatment course indicated they were slightly or moderately satisfied with the therapy.
The regular use of opioids did not change during the study period, but the need for rescue opioids dropped from a baseline dose of 5 mg to 0 mg at the end of the study, which was marginally significant (P = .050).
No adverse events that could have been associated with the therapy were reported.
Support for Scrambler Therapy
There have been a number of previous studies also reporting benefit.
In the United States, a team from the Massey Cancer Center at Virginia Commonwealth University in Richmond reported similar findings using the same cutaneous electrostimulation device for CIPN (J Pain Symptom Manage. 2010;40:883-891).
In that study, 16 patients with CIPN ranging in duration from 3 months to 8 years received 1 hour of scrambler therapy each day for 10 working days. On day 10, all but one of the patients reported a reduction in pain scores — from 5.8 at baseline to 2.3 at 10 days (P < .001). Four patients in this small pilot trial had their CIPN reduced to zero. Again, no toxicity was seen.
Some of the researchers from Virginia Commonwealth University also evaluated scrambler therapy in 39 cancer patients with chronic neuropathic pain (J Pain Palliative Care Pharmacother. 2013;27:359-364). Treatment was given once a day for 10 days over a 2-week period.
NRS scores dropped from 6.6 at baseline to 4.5 at 2 weeks, and remained at similar levels at 1, 2, and 3 months (p < .001). Clinically important and statistically significant improvements were seen in average, least, and worst pain scores, as well as in other measures of pain, the investigators note. No adverse effects were reported in this study either.
An Italian team compared guideline-based pharmacologic treatment with scrambler therapy given once daily for 10 days in 52 patients (J Pain Symptom Manage. 2012;43:87-95). The patients, who were matched by type of pain, had postsurgical neuropathic pain, postherpetic neuralgia, or spinal canal stenosis.
In the pharmacologic group, the mean visual analogue scale score dropped from 8.1 at baseline to 5.8 at 1 month, whereas in the scrambler group, it dropped from 8.0 at baseline to 0.7 at 1 month.
Some patients relapsed, but retreatment and maintenance therapy provided relief and, again, no adverse effects from treatment were observed.
Recent American Study
A recent study was a pilot evaluation of scrambler therapy in of 37 patients with CIPN by Charles Loprinzi, MD, PhD, from the Mayo Clinic in Rochester, Minnesota, and colleagues (Support Care Cancer. 2015 23:943-951). Patients had symptoms for at least 1 month before receiving scrambler therapy, and rated tingling, pain, or both 4 or higher on a 10-point scale during the week before therapy, which consisted of 10 daily 30-minute sessions.
After 10 days of treatment, Dr Loprinzi and his colleagues reported that average pain scores decreased by 53% from baseline (P < .0001) and tingling decreased by 44% (P < .0001). Patients also reported a 37% decrease in numbness (P = .0002).
Despite all these positive results, the uptake of scrambler therapy has been tentative, especially in light of the fact that few if any medications are effective in neuropathic pain. Dr Loprinzi explained that people have been slow to explore its use because scrambler therapy sounds too good to be true.
“People have claimed a lot of things to be beneficial for pain that do not end up coming through,” he told Medscape Medical News.
“I also think you could argue that studies that have been done on scrambler therapy have not been published in the most influential journals, and we do not have absolute proof from what we like to call placebo-controlled multi-institutional trials on scrambler therapy,” he added.
In fact, efforts to conduct larger trials are ongoing, but it takes time and money to do these trials, Dr Loprinzi noted.
“There is a learning curve associated with the use of scrambler therapy,” he added. Most practitioners who offer the treatment have undergone training in Italy. There is a real technique to giving maximally effective therapy.
“The first 25% of our patients did not do as well as the last 75% of our patients, so it’s not the same as taking a pill,” Dr Loprinzi reported. “It takes time to train a person to give it and it takes time for patients to get it, so all these issues come into play.”
Scrambler therapy was not originally developed for the treatment of cancer-related neuropathic pain. Rather, it was developed for chronic pain and, indeed, has been used in many patients with noncancer-related pain, including low back pain, Dr Loprinzi pointed out. But he foresees it having wide applications.
“I have been involved with the treatment of hundreds of patients and I am a believer that scrambler therapy works,” Dr Loprinzi told Medscape Medical News.
This study was sponsored by GEOMC Co. Ltd. Dr Loprinzi reports serving in a consulting or advisory role for Helsinn Therapeutics and receiving research funding from Pfizer.
Eur J Oncol Nurs. Published online December 28, 2015. AbstractJanuary 12, 2016
January 6, 2016
Scrambler therapy is a pain management approach that uses a machine to block the transmission of pain signals by providing non-pain information to nerve fibers that have been receiving pain messages.
The first study on scrambler therapy was published in 2003 by a team of researchers led by Giuseppe Marineo, professor in delta research and development at University of Rome Tor Vergata in Italy. He and colleagues reported that scrambler therapy was effective at reducing pain symptoms in patients with severe, drug-resistant pain from terminal cancer.
The Calmare scrambler therapy device has since received FDA clearance in the United States for use in patients experiencing pain from cancer and chemotherapy, pain as a result of chronic diseases such as diabetes, multiple sclerosis and arthritis, back and neck pain, failed back surgery syndrome, and phantom limb pain among others.
HemOnc Today asked Charles L. Loprinzi, MD, Regis professor of breast cancer research at Mayo Clinic in Rochester, Minnesota, about the safety and efficacy of scrambler therapy, as well as his ongoing research efforts.
Question: Can you describe scrambler therapy and how it came about?
Answer: Scrambler therapy is an electro-cutaneous treatment. Although people may think of it as being similar to transcutaneous electrical nerve stimulation (TENS) therapy, scrambler therapy is felt to work through a different mechanism. TENS is thought to work through the gateway theory of pain relief, whereby normal touch sensations blocks pain sensations. Scrambler therapy, on the other hand, is proposed to provide normal-self, non-pain electrical information via nerves that have been transmitting chronic pain information. Through a process termed plasticity, this is able to retrain the brain so that it does not ascribe pain to the chronic pain area. Scrambler therapy consists of a machine, which looks somewhat like an electrocardiogram machine. Leads are placed on patients, around the areas of chronic pain. Scrambled electrical signals are then sent to the brain that perceives them as normal, non-pain signals. Via this process, the brain is retrained to think that there really is not pain in the area that is being treated.
Q: How and when did you become involved with this treatment approach?
A: I was introduced to scrambler therapy in 2010 by Thomas J. Smith, MD, now at Johns Hopkins University, who had heard about scrambler therapy and decided to try it in patients with chemotherapy-induced peripheral neuropathy (CIPN). He subsequently published a pilot trial that supported that scrambler therapy was an effective approach for treating established CIPN. After some internal debate as to whether I should look further into this treatment approach, which sounded quite strange to me, I did agree to study it. Having now treated more than 200 patients at Mayo, we published a paper on the use of this treatment for chemotherapy neuropathy, which concurred with Dr. Smith’s report, further supporting that this therapy was helpful for CIPN.
Q: What other published data support the value of scrambler therapy?
A: I am aware of 19 published reports regarding scrambler therapy, involving more than 800 patients. Seventeen of these are published manuscripts, whereas two are only published as meeting abstracts. These reports include clinical practice summaries, prospective non-randomized clinical trials and randomized controlled trials, including two trials that sought to double blind patients and investigators. The authors of 18 of the 19 reports concluded that scrambler therapy was a beneficial treatment approach, whereas one report — published only as a meeting abstract and only involving 14 patients — concluded that this was not an effective treatment. Of note, one relatively large randomized trial, with a non-blinded control arm consisting of optimizing medical management of pain, reported substantially more benefit from scrambler therapy than was observed in the control arm. Additionally, a relatively small placebo-controlled, patient-blinded trial reported a statistically significantly beneficial effect for scrambler therapy in a small number of patients with chronic low back pain. Thus, there are substantial data that support the value of scrambler therapy. Having said this, I readily admit that scrambler therapy has not yet been clearly proven to be beneficial. Ideally, additional randomized clinical trials will be reported to provide for more substantial clinical data regarding the true value of scrambler therapy. Dr. Smith is conducting one trial at Johns Hopkins and we, at Mayo, are gearing up for another one. This all takes time, energy and funds.
Q: Can you briefly discuss the findings from the clinical study you reported regarding the use of scrambler therapy in patients with established CIPN?
A: When we received the scrambler therapy machine, we decided to treat patients on a clinical trial as opposed to just using it for routine clinical practice. For this, we developed an open-label clinical trial to document our results and to learn how to provide this therapy. Prior to treating patients on this trial, we went to Rome for training. We then treated patients on this clinical trial, who had chronic pain or neuropathy with a pain and/or tingling score of at least 4 out of 10. In order to report data on a series of these patients, we took the first 37 patients who entered on this clinical trial who had CIPN as their designated clinical problem. We prospectively collected patient-reported outcome data on each of 10 days of treatment and then weekly for 10 weeks following that. Results, reported in Supportive Care in Cancer,illustrated that, during the treatment days, there was approximately a 50% reduction from baseline for pain, tingling and numbness scores. When we then followed the patients weekly, after the 10 days of therapy, the benefit, on the whole, persisted.
Q: Can you describe the treatment process and when beneficial results appear?
A: The area of pain/neuropathy is first defined and a set of leads is placed in normal sensation skin sites, close to the area of pain/neuropathy. The electrodes are then turned on with a gradual increase in intensity to a point where the patient is able to feel sensations, short of pain. When successful, the patient reports that the buzzing sensation has replaced an area of pain/neuropathy. This generally occurs within a minute or two. At times, electrodes need to be moved to obtain this sort of success. Sometimes, several sets of electrodes are needed to cover the area of discomfort. The scrambler machine stays on for about 30 minutes following successful electrode placements. The electricity is then turned off and the patient commonly reports that the pain/tingling is still markedly improved. After one treatment, the benefit is often relatively short-lived, lasting for minutes to hours. With repetitive days of treatment (standardly up to 10 treatments, although stopped earlier if the problem goes away completely and lasts overnight), the period of benefit increases until it lasts for a couple days. The benefit largely persists for weeks to months. Some patients relapse and can be successfully retreated, oftentimes only needing an additional few doses.
Q: Is this therapy routinely offered at Mayo Clinic?
A: Mayo recently began offering scrambler therapy as part of clinical practice. As with many new practice approaches, there are many questions that arise: How effective is the therapy? Who should be treated and for which conditions? How well is this approach covered by different insurance carriers? Admittedly, we do not have ideal answers for these and many other questions, but we are cautiously proceeding forward. There is considerable demand for scrambler therapy along with concerns that efficacy has not been proven and that the reported results from it sound too good to be true. But, these concerns are not too surprising, as there is often a wariness when a new therapy is initiated.
Q: Is this therapy routinely offered at places other than Mayo Clinic?
A: Yes, it is available at other select places. I understand there are more than 30 institutions in Italy and even more institutions in South Korea that provide scrambler therapy as a part of clinical practice. Multiple United States military institutions also offer scrambler therapy. In the United States, I estimate that there are between 15 and 30 sites that are actively offering this treatment. It should be noted that there is a learning curve in terms of making this therapy work. For example, in our paper where we looked at CIPN, even though we had reasonably good experience which included visiting the inventor in Rome and being trained by him, we did a whole lot better with the later patients we treated than we did the first 25% we treated.
Q: What type of feedback have you received on the therapy?
A: There are patient testimonials, which can be found on the Internet, whereby patients swear by this therapy. In line with this, I have seen some phenomenal results in patients. We have clinical trial data that asked patients, daily while they were receiving 2 weeks of outpatient therapy and then weekly for 10 weeks of follow-up, whether they would recommend this treatment to others. Approximately 80% of the replies noted that they would recommend it, 1% said that they would not and the rest said that they were unsure. There, admittedly, are some people who say this therapy did not work for them.
Q: How much of an issue is cost?
A: There are the issues regarding the cost of the machine, the cost of training and whether insurance companies cover this therapy. There are some insurance companies that cover the therapy, having realized that it is a lot cheaper than alternative therapies that might be employed for the same patient problem. This is certainly an evolving process. The cost can run anywhere between $200 and $500 per session, and up to 10 sessions may be recommended. This is less expensive than some other procedures and therapies employed for chronic pain, such as spinal cord stimulators. There are some patients who choose to pay for the treatments on their own, if not covered by insurance.
Q: Are there any side effects associated with this therapy? Do they outweigh the benefit, in your opinion?
A: There have not been many documented side effects with this therapy. People feel a buzzing sensation when the machine is working and sometimes this can be uncomfortable. If pain happens during the procedure, the signal intensity should be turned down and/or off. At times the electrode leads can be moved to an alternative site, sometimes by just a couple centimeters. Occasionally, patients may develop some skin irritation or bruising under the sites of the leads. There have been some patients who report more pain in the day or days following the treatment, but it is not apparent that this is more than the normal process of a waxing and waning of the baseline pain. Overall, the reports in the literature have been largely free of side effects.
Q: Is there anything else you would like to add?
A: Although if I consider myself to be a fairly conservative clinician and have not been shy about publishing negative results from many clinical trials, I do believe that scrambler therapy works. This contention is based on the knowledge that the majority of the reports in the literature are positive an also the personal experience I have observed in many patients, including seeing dramatic reductions of symptoms in some patients that did not derive similar benefit from previous treatment approaches. – by Jennifer Southall
For more information:
Charles L. Loprinzi, MD, can be reached at Mayo Clinic, 200 1st St. SW, Rochester, MN 55902; email:email@example.com.
Disclosure: Loprinzi reports that scrambler therapy machines/supplies were provided to Mayo for conduct of clinical trials.January 7, 2016
Each year after their big Thanksgiving meal, Tess Wilson’s family has a tradition of playing games in a gym to burn off some calories. For much of her high school and college years, Tess spent that afternoon sitting on the sidelines watching the rest of her family run around. Severe, chronic pain made it impossible for her to join in the fun.
Thanksgiving Day 2014 was different. On that day, Tess was in the thick of the action. She played capture-the-flag, hide-and-go-seek, soccer and tag.
“I was incredibly sore the next day, but not in a chronic pain way,” she says. “I just used muscles that I had forgotten were there.”
The change came as a result of Tess’ participation in a a clinical research trial at Mayo Clinic that studied the effects of a new treatment for chronic nerve pain, called scrambler therapy. After two weeks of the therapy, Tess found relief from the constant pain that had been plaguing her for five years.
Fighting daily pain
At 17, Tess was a high school varsity athlete. She enjoyed being active and ran in 5K races. That year she suffered an injury to her right foot. Although the damage seemed minor, the pain wouldn’t go away. As time went on, it got worse, spreading from her foot, up her shin, into her knee.
Tess was diagnosed with complex regional pain syndrome. It’s an uncommon form of chronic pain that usually affects an arm or a leg. The condition typically develops after an injury, surgery, stroke or heart attack. But the pain is out of proportion to the severity of the initial injury. Symptoms may change over time, and they can vary from one person to another. The most common symptoms are continuous burning or throbbing pain, swelling, redness and hypersensitivity, particularly to cold and touch. The condition can be debilitating, and effective treatment often is hard to find.
“I was in pain almost every single day,” says Tess. “I went from running 5Ks to relying on crutches or pain medications just to walk around the grocery store. My skin became so hypersensitive that a sock or even a slight breeze would cause excruciating pain.”
Tess tried treatment after treatment. Nothing provided consistent relief. In the fall of 2014, the pain was intense, and Tess felt like she was stuck. When she heard about the scrambler therapy study at Mayo Clinic, Tess was eager for the chance to try an innovative solution. But in light of her lack of success with other treatments, she wasn’t particularly optimistic.
Retraining the brain
Doctors suspected Tess’s complex regional pain syndrome was a result of nerve damage. The damaged nerves were sending inaccurate signals to her brain that triggered the pain she felt in her foot, shin and knee.
Scrambler therapy works by using a nerve stimulation device to mix another signal into the transmission from the damaged nerves to the brain. Basically, it replaces the information that signals pain with information that does not signal pain. The therapy involves placing electrodes connected to the scrambler device on the skin near damaged nerves. The scrambler sends painless electrical signals to those nerves that they relay to the brain. The new signals break the pain cycle and retrain the brain to understand that it is not really experiencing pain.
“The first day I was hooked up to the scrambler, I didn’t know what it to expect,” says Tess. “The buzz and prickle of the electricity was such a foreign sensation. It wasn’t painful, but not quite pleasant. It almost tickled. One of the buzzing waves washed over a particularly painful area of my knee and replaced the pain with the buzzing, only for a moment and only in that spot. I was surprised, but I held onto my skepticism.”
Slowly, though, Tess began to notice a big difference. After five days of scrambler therapy, she was able to relax in a hot tub — a luxury she hadn’t enjoyed since her original injury because both water and temperature changes usually made her pain skyrocket. By the end of her two-week treatment, she could walk pain-free for the first time in years. Her sleep had also improved dramatically because she could go to bed without discomfort at night.
Looking to a brighter future
Tess finished her treatment just before Thanksgiving 2014, when she was finally able to join in the games with her family. Over the next month, the pain remained at bay. She started a part-time job and began running again.
As can sometimes happen for people undergoing scrambler therapy, Tess began to notice the pain slowly returning throughout the next several months. In April 2015, she went back to Mayo Clinic for a four-day booster treatment with the scrambler. The results did not disappoint her, and Tess is now optimistic about the long-term possibility of keeping her chronic pain in check.
“I had accepted the fact that I’d probably live my entire life in pain,” she says. “Now, the scrambler is working wonders for me. For the first time in five years, I feel like I’ve finally found a treatment that can permanently change my future.”October 20, 2015
March 02, 2015 by Rachel Lutz
Pediatric complex regional pain syndrome (CRPS) can be treated using a scrambler therapy (ST), Calmare, according to research presented at the American Academy of Physical Medicine and Rehabilitation Annual Assembly held November 13-16 in San Diego.
Researchers from Utah Valley Pain Relief introduced scrambler therapy called Calmare as a noninvasive neuromodulation approach to the treatment of chronic neuropathic pain. The ST is thought to interfere with the pain neuromatrix by providing nonpain codes. Though the therapy was originally developed to treat pain in cancer-related neuropathic pain and chemotherapy induced peripheral neuropathy patients, it had since been successfully used to treat a variety of chronic pain symptoms. However, it has not been widely tested for pediatric patients, which the researchers aimed to rectify in their current research.
“In our opinion, the multidisciplinary care model best fits the treatment model for this diverse patient group, allowing flexibility for individual patient needs while encouraging peer, family, and team support, with the goal of sustained ongoing progress and recovery,” the authors wrote after conducting a literature review, which determined children with chronic neuropathic pain respond better to noninvasive approaches to pain management.
By identifying the nervous system as a cybernetic system that responds to nerve pain as coded information, researchers were able to pinpoint when chronic pain receptors have been damaged. They noticed it created erroneous codes that were independent from the pain source. The researchers saw the pain signals reinterpreted by the brain; otherwise, the signals were continuing to be interpreted as pain signals back to the body. Calmare was used to intercept these pain signals and send non pain signals back to the brain. Calmare positively impacted the effort to decrease the various forms of neuropathic pain.
In a case study, researchers concluded the ST Calmare pain therapy was appropriate for treatment of pediatric complex regional pain syndrome. “There are many people looking for insights and answers about Calmare,” Erick Bingham, DC, from Utah Valley Pain Relief said in a press release. “There are many children with CRPS who can benefit from these treatments. This case study reveals in a practical way what’s possible with the right information and guidance.”
See more at: http://www.hcplive.com/news/Noninvasive-Therapy-Used-to-Treat-Pediatric-Complex-Regional-Pain-Syndrome-#sthash.XxVzXSYs.dpuf
Source: http://www.hcplive.com/March 5, 2015
Insurance Giant to Reimburse NYC Rehabilitation Center for Its Calmare Therapy Treatments
FAIRFIELD, Conn., June 30, 2014 /PRNewswire/ — The Calmare(R) Pain Therapy Device, the flagship product of Competitive Technologies, Inc., (OTCQX: CTTC) (CTI), the pain mitigation company, gained a favorable reimbursement ruling from the New York City Civil Courts in a personal injury case against Allstate Insurance, Co., (Allstate). In the ruling, the Court instructed the insurance giant to reimburse Forest Rehabilitation Medicine P.C. (Forest) for its use of Calmare pain therapy (Calmare) on patients who suffer pain as a result of car accident injuries.
In the New York Civil Court case, Forest Rehabilitation Medicine P.C. v. Allstate Insurance Company, New York Civil Court Judge Theresa Ciccotto rejected Allstate’s claim that Calmare, which has been cleared by the U.S. Food and Drug Administration (FDA), is an unproven method. In granting the clinic’s bid for the reimbursement, Judge Ciccotto cited the FDA’s approval of the treatment and said that she was not concerned about a lack of studies on the long-term effects. This was the first published decision in the U.S. involving the medical necessity of Calmare therapy.
Forest, which has clinics in Staten Island and Brooklyn, last year became the first practice in the United States certified in the treatment. Dominick Gullo of the New York-based law firm, Cassandra & Gullo successfully litigated the case in behalf of Forest. Continue readingJuly 1, 2014
Source: The Wall Street Journal
FAIRFIELD, Conn., June 11, 2014 /PRNewswire/ — Competitive Technologies, Inc., (OTCQX: CTTC) (CTI) the pain mitigation company, today announced that the Emmy(R) award winning TV program “The Doctors” recently featured a medical case involving a young patient living with Complex Regional Pain Syndrome (CRPS) — a long-term chronic disease characterized by severe chronic pain, swelling, and changes in the skin that often worsens over time.
The show featured CTI’s flagship product, the Calmare(R) Pain Therapy device, as a non-invasive pain therapy solution alternative instead of the large host of medicines that Matthew currently uses to address the debilitating pain from CRPS. Continue readingJune 11, 2014
Dr. Jack D’Angelo, M.D. offered some insights on how Calmare Therapy works. Watch the segment here: http://www.thedoctorstv.com/videolib/init/11692
The American military is one of the world’s largest providers of Calmare® Therapy; the device is offered at medical centers in every branch of service. Patients rely on Calmare® to treat a variety of chronic neuropathic pain conditions, particularly phantom limb syndrome, failed back surgery syndrome, post-herpetic neuralgia, brachial plexus neuropathy, complex regional pain syndrome, and sciatic and lumbar pain.
Read Sergeant Savage’s story on how he has survived, even prevailed, through grit, his family and a radical experiment in managing pain without narcotics.
May 30, 2014