Journal of Pediatric Nursing | 2019
Scrambler Therapy: Implications for Chronic Pain Relief in Pediatrics
Abstract
Pain is a physical sensation experienced through a perceived or actual tissue injury (Majithia et al., 2016).When symptoms of pain persist outside the time of tissue injury and healing, it can be maladaptive and considered a chronic disease state (Majithia et al., 2016). Conventional treatments of chronic pain consist of opioids, neuroleptics, physical therapy, regional anesthesia, and neuromodulation (Campagnone & Tagliaferri, 2015). Both adults and children experience chronic pain. Characteristics of chronic pain are symptoms that endure or reoccur for at least threemonths (Park, Kim, Kim, & Yoo, 2017). Common conditions causing chronic pediatric pain (CPP) include cancer related neuropathic pain associated with platinum-based chemotherapeutic drugs (e.g. Cisplatin) (Park et al., 2017) and complex regional pain (CRP) a type of chronic neuropathic pain that is characteristically contained to one limb and develops due to a noxious stimulus from trauma, surgery, or a stroke (Raucci et al., 2016). Children who experience chronic pain develop alterations in performing daily activities, which in turn may have an undesirable impact on the child ‘s physical, psychological and social well-being (Park et al., 2017). The goal of treament is to reduce pain to improve the child s quality of life (Majithia et al., 2016). Given the increase in prescription opioid misuse there is a need to develop alternative approaches for treating chronic pain (Lesenskyi, Maxwell, & Cruciani, 2017). Scrambler Therapy (ST) is a noninvasive, electrocutaneous stimulation (neuromodulation) device that may prove to be a safe alternative for chronic refractory pain treatment in children. The majority of ST research demonstrates relief of symptoms in neuropathic andmixed pain syndromes in adults without serious side effects. The Food and Drug Administrations (2009) approved the Scrambler Therapy MC-5A TENS Device for: “1) Symptomatic relief of chronic, intractable pain, postsurgical, and post-traumatic acute pain, 2) Symptomatic relief of acute pain, and 3) Symptomatic relief of post-operative pain” (pp. 5-1, 5-2). Clinical trials show promising results of ST for treating chronic pain in adults (Congedi et al., 2016). This columnwill review ST, current clinical trials, application to pediatric chronic pain, disadvantages, and contradictions to the treatment.