Electricity as chronic pain medicine

You might be willing to try anything to relieve chronic pain, even getting zapped with tiny shocks of electricity. The concept began evolving long before Ben Franklin conducted his famous experiments with a kite and a key; for example, the ancient Greeks used the natural electrical discharges of torpedo fish to relieve headache and gout. Eventually, as scientists figured out what electricity was and how to use it safely, they applied it to medicine. Today, there are several types of "electroceutical" therapies available to treat pain. Three have our attention.

TENS therapy

In transcutaneous electrical nerve stimulation (TENS) therapy, a machine sends pulses of non-painful, low-intensity electricity to electrodes placed on the skin. The strength of the current and the frequency of the pulses (the number per second) remain consistent throughout a 20-minute session.

How does TENS work to quiet pain? "The electrical stimulation closes the 'gate' that allows pain signals to get to the brain. It's just like when you were a kid and got an 'ouch.' Your mom might have told you to rub it to make it feel better. That was enough to close the gate," explains Vitaly Napadow, director of the Scott Schoen and Nancy Adams Discovery Center for Recovery from Chronic Pain at Harvard-affiliated Spaulding Rehabilitation Hospital.

You can go to a practitioner (such as a physical therapist) for TENS therapy or purchase a home TENS unit (about $25 and up). Medicare sometimes covers the costs.

Electroacupuncture

Like TENS therapy, electroacupuncture interrupts pain signals by delivering a consistent frequency of jolts at a certain strength. Instead of being delivered via electrode patches on the skin, it's delivered with acupuncture — hair-thin needles inserted at specific locations in the body. Electrodes are clipped onto the needles and then charged with electricity. "The needles allow the current to penetrate deep underneath the skin, to muscles, tendons, and deeper nerves," Napadow says. "The treatment has the added benefit of acupuncture, which — in traditional Chinese medicine — is believed to affect energy channels. Modern medicine has found that acupuncture can adjust signaling molecules in the nervous system."

Electroacupuncture is available only from a private practitioner or clinic. Sessions cost about $100 per hour, which is often covered in part by Medicare or private insurance.

Scrambler therapy

Scrambler therapy is a newer treatment that sends low-intensity electrical currents to electrodes on the skin. But the frequency of the pulses isn't steady; it changes constantly, with a goal of scrambling — not inhibiting — pain signals and replacing them with non-pain messages. The information is then perceived as a pleasant sensation, tingling, or itching.

Scrambler therapy is found in hospitals or clinics, but it's not widely available. Most insurance companies don't cover the costs, which can be hundreds of dollars per session.

Are they effective?

Experts debate whether electroceutical therapies can zap away chronic pain. TENS therapy and electroacupuncture are well established, and some people swear by them for relief. But they don't work for everyone, and research has produced mixed findings.

"TENS therapy has lost some favor because it's thought that the effect isn't long-lasting. But I think a lot of that has to do with the parameters used in stimulation. At lower frequencies, you might be able to get longer-lasting results," Napadow says. "And some evidence has shown that electroacupuncture can last for months after therapy. But you can't do it by yourself at home, like you can with TENS."

What about scrambler therapy? A review of small preliminary studies published July 13, 2023, in The New England Journal of Medicine found that scrambler therapy reduced chronic pain in 80% to 90% of study participants, that it might have long-lasting effects (months or years), and that it might be more effective than TENS therapy. But we'll need more research to confirm the findings.

Is it right for you?

Stay away from electroceuticals if you have any kind of implanted stimulation device, such as a pacemaker or bladder stimulator.

Good candidates for electroceutical therapies are people who have chronic pain, such as arthritis, neuropathy (chronic tingling or pain in the limbs), neck or back pain, or pain from cancer treatment. Potential side effects include skin irritation from electrode patches, burns (which are rare) from electrodes, bleeding from acupuncture needles, dizziness, headaches, nausea, or worsened pain. "Yes, there are risks, but in general they are lower than the potential for side effects from many pain medications," Napadow says.

Get your doctor's okay before seeking treatment, especially if you have a heart condition such as an abnormal heartbeat. And make sure your electroceutical therapy clinician is a licensed health professional who's trained to provide treatment.

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