Category Archives: Chronic Pain

CES for headaches in your life

CES would intuitively be useful in the treatment of headache, not only because it is stress reducing, a commonly accepted cause for many headaches, but because it stimulates across the theoretical pain message centers in the cortex of the brain.

In the 1970s, a student completed his graduate thesis by studying 18 patients with migraine headaches. The study involved a treatment group, a sham treatment group and a placebo control group.  CES treatment was given 45 minutes a day for 15 days, Monday through Friday, and while the results were highly variable, a significant reduction in intensity and duration of headaches was found among the treated group.  There was no placebo effect from the treatment.

Solomon and his group studied 112 patients with tension headaches.  To be in the study, patients had to have at least four headaches a week for a year, and these had to be so severe they required treatment with prescription medications.  The patients were asked to use CES for 20 minutes each time they had a headache, and if the pain did not go away, to use it for a second 20 minutes.  The study lasted for 10 weeks and the treated patients reported an average pain reduction of 35%, while the sham treated patients reported an 18% improvement.      

Another study of migraine patients compared the effects of CES alone, biofeedback alone, or the two together.  The treatment lasted eight days and the patients were followed monthly for three months, in which they were asked to rate the number and intensity of headaches.  Both biofeedback and CES groups improved significantly more than the controls, and both groups continued to improve at each 30 day follow-up period, but it was found that CES potentiated the biofeedback gain by more than 70% by the third, 90 day period.

Romano studied the ability of CES to reduce headaches in 100 fibromyalgia patients who were asked to use a CES device for four, 20 minute treatment periods each day for up to two months.  In this open clinical study the patients rated their improvement at 50% or greater in terms of reduced headache frequency and intensity.

Forty-seven physicians who treated 151 headache patients with CES rated the treatment gain in 90% of them to be 25% or better.

Patient warranty cards indicate that 118 patients who suffer from migraine headaches improved an average of 61%, while 112 who suffer from tension headaches improved 56%.  That improvement is somewhat lower than in the migraine group, possibly due to neuromuscular involvement in neck or shoulder muscles that did not receive stimulation from CES

CES being used in pain clinics

CES units were becoming more widely used in pain clinics at the dawning of the 21st century. The clinics typically do not wait for pain studies to be completed, but simply try CES with their patients to see what effect they can observe, then compare it with their historical experience with those same types of patients. A typical such clinic is one just outside Dallas, Texas. A nursing assistant puts CES electrodes on patients as they enter the waiting room to await their turn with physicians or other therapists. The wait can vary from a few minutes to a half hour, depending on the patient load at a given time. The patients complete a 10 point self rated pain score prior to receiving CES. When they are called into treatment by the treatment staff, the CES is removed, the amount of time they were on the device is recorded, as a post CES self rated pain score if obtained.

The clinic has become so enthusiastic about the results, that this protocol has become a permanent part of their core treatment program. They now enthusiastically prescribe CES home units for their large number of patients who now request them, and the staff reports their clinic is much more effectively treating chronic pain than they were previously.

Pain clinic treatment results have been published, however. An interesting CES study was completed in a pain clinic near Bombay, India, in 2001. It was an open clinical trial of CES, used alone as a treatment of pain patients who had been refractory to all other previous efforts of treatment of their pain at the clinic. They were given CES treatments one hour per day, 5 days a week, for three weeks. They were asked to rate their pain level on a VAS scale of 0 to 10, with 10 being the most intense pain. Following treatment their mean self reported pain level had been reduced by 62%. Analyzing the data for individual patients it was found that 15% of the patients did not respond to the treatment, 30% gained total relief, while the remainder of the patients claimed significant relief ranging from 33% to 94%.

Surprising Uses for Electromagnetic Pulse Therapy


By administering energy in controlled, coherent pulses, physicians can use electromagnetic pulse therapy to treat wounds, chronic pain, and alcoholism. While research supports the benefits of this type of therapy when performed by professional physicians using clinical instruments, it does not support claims that electrotherapy mats and home devices effectively treat soft tissue pain. This article, then, looks only at professionally administered therapies.

Wound Healing

Low-intensity direct current (LIDC) is safely administered by placing the electrodes from the LIDC instrument onto the surface of the skin. A very small amount of electric current flows in one direction to the site and creates a magnetic field around the wound. This creates an effect known as galvanotaxis, which causes fibroblasts and keratinocytes to travel to the wound and begin to heal tissue upon reaching the damaged area. In studies, this effect has been shown to increase the rate of healing by 100% to 150%. It also makes the resulting scar tissue more resistant to future damage.

In addition, LIDC has antimicrobial effects. In two studies, patients who received LIDC experienced no infections and less discomfort at their wound sites. Typically, treatment is administered for 60 minutes each day until the wound is healed.

Depression, Pain, and More…

ces ultra treatmentCranial electrotherapy stimulation (CES) is another type of electric procedure approved by the FDA when administered by trained physicians and health providers. In this treatment for depression, insomnia, and anxiety, electrodes that are placed on the ears send a small electric current into the brain. This deactivates certain portions of the brain, which mitigates symptoms of neural imbalance and hyperactivity by controlling neurotransmitter release and neuron signaling patterns.

This deactivation has also been shown to reduce the pain symptoms of fibromyalgia. Patients using CES devices report that they experience a decrease in chronic pain, and MRI scans confirm that this is due to a deactivation of pain signaling in the brain.[8] Fibromyalgia patients using CES have been shown to experience a 28% reduction in tenderness, a 27% reduction in pain intensity, and a 55% improvement in quality of sleep. Similarly, patients who use CES therapy for spinal cord injuries report a significant decrease in pain intensity.


CES has also been used to treat the symptoms of alcohol withdrawal. Studies show that CES can help alcoholics to reduce their alcohol consumption as well as the stress and depression associated with quitting. The treatment plan consists of daily 30-minute sessions over a period of four weeks. Additional studies indicate that the calming effect of CES also reduces anxiety symptoms in alcoholics.

How To Find Effective Electrotherapy

This discussion of electrotherapy comes with two important caveats. The first is that home use electrotherapy mats are not proven to be effective at relieving soft tissue pain. The pain relief described here is a result of direct current being applied to the brain by clinical CES devices that are operated by physicians. Mats are not shown to achieve this result.

The second important note is that CES shuts down parts of the brain. This makes it an effective method for relieving symptoms, but like medication, it is not a cure or remedy. The advantage that CES has over medication is that CES does not elicit side effects. As FDA-approved treatments, LIDC and CES are available at clinics that specialize in trauma therapy and rehabilitation, and are likely to be covered by most insurance companies. Natural Health Advisory Institute has a searchable physician or practitioner directory where those practicing electrostimulation therapy can be located.

Microcurrent Electrical Therapy and Cranial Electrotherapy Stimulation for Pain Control

Kulkarni, Arun D. and Smith, Ray B. The Use of Microcurrent Electrical Therapy and Cranial Electrotherapy Stimulation in Pain Control.  Clinical Practice of Alternative Medicine. 2(2):99-102, 20-1.

This open clinical study, conducted by Dr. Kulkarni, an anesthesiologist working with orthopedic surgeons at a pain clinic at Nav-Durga hospital near Bombay, India, was designed to assess the effectiveness of Alpha-Stim microcurrent electrical therapy (MET), cranial electrotherapy stimulation (CES) or a combination of both therapies. 20 patients who had been refractory to previous treatments completed informed consent and joined the study in the order that they presented at the first author’s hospital pain clinic. Ages ranged from 30 to 75 years (mean=44). 15 were females. Treatments were provided for one hour daily, Monday through Friday, for 3 weeks. No pain medications were taken during the study period. MET was given via probes or self-adhesive electrodes at 600 microamperes, while the current for CES was regulated by each patient, ranging from 100 to 300 microamperes. Pain was scored on an 11 point self rating VAS scale, with 0 being no pain and 10 being the most intense pain they had experienced to date.

Nine patients (45%) left the study early following reduction of their pain to a level between 0 and 1.5 on the 11 point scale. One had complete remission of her pain after only 2 treatments. Of 3 patients who received no relief, none returned for the final week of treatment. 7 patients (35%) who were treated with CES plus self-adhesive electrodes began at an average pain level of 7.7 (range 5-10) and ended with an average of 3.7 (range 0-10), or a 52% reduction in pain from an average of 12 days of treatment. 7 patients who were treated with CES plus probes fared even better beginning with a pain level of 7.1 (range 4-8) and ending at an average of 1.1 (range 1-6), or an 85% reduction of pain from an average of 8.1 days of treatment. 5 patients (25%) were treated with CES only. They experienced an average of 50% drop in their pain level from 4.4 (range 3-7) to 2.2 (range 0.5-5) with an average of 10.6 days of treatment. No negative side effects were reported. The authors concluded that MET and CES are effective treatments for chronic pain patients.

Table 1. Subject Characteristics, Treatment Parameters and Treatment Outcome
Pt Sex Age Type of Pain and Duration Nr.
Rx Given* Pre-
1 F 30 Bilateral scapular, 5 yrs 15 C,A 7 0 100%
2 F 30 Radiating, neck to hand, 10 yrs 15 C,A 8 1 88%
3 F 62 Rheum. arth., bilateral, knees, 4 months 5 C,P 8 0 100%
4 F 40 Low back pain, 7 yrs 15 C 3 2 35%
5 F 35 Radiating pain, C7 to right arm, 6 yrs 12 C,P 8 0 100%
6 M 41 Back pain, T8, 1 year 10 C,A 5 1 80%
7 F 30 L3 & L4 pain, 6 yrs 12 C,A 8 0 100%
8 F 46 Low back, 2 yrs, both knees, 1 yr 10 C 6 3 50%
9 M 52 Ankilosing spondilosis, 10 yrs, rheum. arth. 10 C,A 8 7 13%
10 M 40 Back pain, 4 yrs 15 C,P 7 0 100%
11 F 48 Fibromyalgia, 1 yr 10 C 5 0.5 90%
12 F 41 Fibromyalgia, 3 yrs 8 C 5 0.5 90%
13 F 31 Rheumatoid arth., rt leg to toe, 5 months 10 C,P 4 1.5 63%
14 M 75 Low back, knee, 7 yrs 10 C 5 5 0%
15 F 40 Pain, left heel, 1 yr 10 P 6 6 0%
16 F 65 Sciatica, 3 yrs 8 C,P 7 6 14%
17 F 42 Rt knee pain, stiffness, 7 months 2 C,P 8 0 100%
18 F 42 Cervical spondilosis, 2 yrs 15 C,A 8 7 13%
19 M 44 Cervical spondilosis, 2 months 5 C,P 8 0.5 94%
20 F 44 Bilateral knee, osteo-arthritis, 4 yrs 7 C,A 10 10 0%
*P = Probes; C = CES; A = Self Adhesive Pads
** 10 Point VAS Scale

CES vs. drugs in the treatment of chronic pain

Many primary care physicians are stymied and frustrated by the challenge of treating chronic pain. In particular, they face patients with bona fide pain but who also have depression, anxiety, insomnia and substance abuse. With regards to treatment interventions, they are damned if the do and damned if the don’t offer treatment with various classes of analgesic medications, including narcotic medications. They are particularly afraid of the increasing fatalities occurring with the use of narcotic analgesic medications in combination with benzodiazepines and antidepressant medications. They welcome alternatives to medications for those patients whose emotional distress intensifies their suffering and pain sensation. CES could provide a safe alternative for them that do not currently exist.

Excerpts from “A View from the Trenches” written by Jason Worchel, M.D.

More CES Research –