UH Joins Elite Few in Offering ‘Scrambler Therapy’ for Patients with Pain
September 17, 2023
UH Clinical Update | September 2023
Patients with neuropathic pain from chemotherapy-induced peripheral neuropathy and other causes have a new, non-invasive treatment option at University Hospitals – an option available at just two hospitals in Ohio and limited to only major cancer centers across the U.S.
What it is: The new option is known as scrambler therapy. Approved by the U.S. Food and Drug Administration in 2009, it involves administering electrical stimulation to the patient’s skin via electrodes, placed strategically around where the patient experiences chronic pain. By stimulating nerves along mapped areas of the skin that rely on specific nerve connections (dermatomes), the goal is to replace painful nerve signals with non-painful ones, thus “scrambling” how pain is perceived in the brain.
Different from TENS: Many people are familiar with transcutaneous electrical nerve stimulator (TENS) devices. “Scrambler therapy is different,” says pain medicine specialist Henry Vucetic, MD, from the UH Pain Management Institute, who is leading the new program at UH alongside Santosh Rao, MD, Medical Director of Integrative Oncology for UH Connor Whole Health.
“TENS is a tonic stimulation -- a consistent stream of pulses at a set frequency, pulse width and amplitude,” Dr. Vucetic says. “You typically wear the device for about 30 to 45 minutes, and it provides treatment for the time that the device is on top of you. The scrambler machine, on the other hand, actually comes with a lot of neurophysiology research behind it. It runs this pulse stimulation pattern that mimics the burst pattern within our central nervous system.”
The patient experience: During the first visit for scrambler therapy, patients undergo an initial evaluation and dermatome mapping of their painful areas. They then undergo one-hour sessions with the scrambler machine on three successive days, with a handful more sessions added if the therapy is proving effective.
“If there is sustained relief, we will finish a total of seven visits,” Dr. Vucetic says. “The patient then will come back for one or two booster visits moving forward.”
Who can benefit: Dr. Vucetic and Dr. Rao say the initial focus of scrambler therapy at UH has been with cancer patients. But they say it is effective for many more different sources of pain, including:
- Chemotherapy-induced peripheral neuropathy (CIPN)
- Phantom limb syndrome
- Post-surgical neuropathic pain
- Reflex sympathetic dystrophy
- Postherpetic neuralgia (PHN)
- Peripheral neuropathy
- Treatment-resistant neuropathic pain
“Scrambler therapy has the benefits of being non-invasive, painless, with few to no contraindications for use and few to no adverse side effects,” says Dr. Rao.
Patient first: The new scrambler therapy option is just one more way UH is working to reduce the use of narcotics and the potential for medication misuse. “We felt that there was a need,” Dr. Rao says. “Because of chemotherapy, primarily, we have a lot of patients with neuropathy who have ongoing symptoms that can be debilitating, causing lifelong pain. They have to take narcotics or other medications to suppress the pain, and even then sometimes they don't have relief. So this is a new option for them.”
Dr. Vucetic and Dr. Rao say they’ve also gone to great lengths to make the program convenient. Patients undergo scrambler therapy in quiet rooms at the UH Mentor Wellness Campus with piped-in music, if they choose. Wi-fi is available for those who want to work on a laptop during their therapy session. Plus, UH strives to give access to this therapy to all patients by offering different types of payment arrangements, including insurance or cash pay option.
“Rather than have this be a program for the few and for those who can afford it, we really want this to be a program that meets the needs of the patients,” Dr. Rao says.
And with growing demand from patients, Dr. Vucetic sees continued growth for scrambler therapy at UH.
“We fully intend to expand if we need to, because there are a lot of patients with these symptoms,” he says.