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.
The Treatment of Fibromyalgia with Cranial Electrotherapy Stimulation.
In cranial electrotherapy stimulation (CES), microcurrent levels of electrical stimulation are passed across the head via electrodes clipped to the ear lobes. After successful clinical use of CES with fibromyalgia patients in our clinic, it was decided to test these results with a double-blind, placebo-controlled study in which 60 randomly assigned patients were given 3 weeks of 1-hour-daily CES treatments, sham CES treatments, or were held as wait-in-line controls for any placebo effect in the sham-treated patients.
Treated patients showed a 28% improvement in tender point scores, and a 27% improvement in self-rated scores of general pain level. The number of subjects rating their quality of sleep as poor dropped from 60% at the beginning of the study to 5%. In addition, there were significant gains in the self-rated feelings of well-being and quality of life, plus gains in six stress-related psychological test measures. No placebo effect was found among the sham-treated controls. A theoretical role of CES in affecting the brain’s pain message mechanisms and/or neurohormonal control systems is discussed. It is concluded that CES is as effective as the drug therapies in several trials, with no negative side effects, and deserves further consideration as an additional agent for the treatment of fibromyalgia.
As many as six million Americans are living with fibromyalgia, and in most cases they are living with the constant, unrelenting symptoms of the condition: widespread pain in muscles and joints, sleep disturbances, irritable bowel syndrome, and anxiety, to name a few. But very positive results from a new study suggest that sending mini-currents of electricity through the brain — a procedure called cranial electrotherapy stimulation –may provide relief from some of these symptoms.
Alan S. Lichtbroun, MD, says he learned about the electrotherapy technique while searching for better treatments for his many fibromyalgia patients.
“This technique is gaining wide acceptance at chronic pain treatment centers,” says Lichtbroun, assistant professor at Robert Wood Johnson Medical School, in East Brunswick, N.J. “At first I looked at this device very skeptically — and even now I am beginning to see some patients who had a marked response at the beginning are gradually beginning to deteriorate — so again I wondered if the machine had lost its power. But what I’ve found is that patients eventually lose their incentive to use the machine, and less frequent use appears to mean a return of symptoms.”
Read more – http://www.webmd.com/fibromyalgia/news/20010501/cranial-electrotherapy-fibromyalgia
Cranial Electrotherapy Seems Promising for Fibromyalgia was last modified: October 2nd, 2014 by cesadmin
Finally, noting that CES is apparently an effective treatment for pain, several studies have been done to assess its potential to potentiate the effects of analgesics. One anesthetist gave 90 urological patients and 30 abdominal surgery patients N2O (nitrous oxide) in concentrations of 75%, 62.5%, or 50% alone, or in combination with CES during surgery. After 20 minutes patients were given a painful stimulation with Kocker clamps on their inner thigh for one minute. It was found that CES increased the potency of all three levels of N2O by 37%.
In a more elaborate study, 50 patients underwent urological operations with anesthesia induced with doperidol, diazepan, and pancuronium. Half the patients also were given CES treatment during the surgery. Anesthesia was maintained as necessary throughout the surgery by an IV fentanyl drip. Those patients receiving CES required an average of 33% less fentanyl to maintain anesthesia than did those who were not receiving CES.
It was found in both of the above two studies, that analgesia was maintained for a longer period following surgery among those patients receiving CES, than among those who did not.
CES can potentiate the effects of analgesics was last modified: October 14th, 2013 by cesadmin
In the last decade of the 20th century, several well controlled, double blind studies sought to discover what, if anything CES treatment could do to alleviate the sometimes intractable pain of fibromyalgia. It was found that Patients given CES treatment reported the same reduction in tender point pain and self-rated overall pain level that they reported when treated with multiple medications, but without any of the negative side effects or great financial outlay.
Another study found a 29% reduction in the pain of patients suffering from multiple sclerosis following four weeks of daily CES treatment. Serendipitously, it was also found that they experienced a 40% reduction in their fatigue score, a 45% reduction in self-reported sensory deficits, a 50% reduction in their MS related vision problems and a 53% reduction in problems with spasticity.
Other studies have found CES clinically effective in reducing pain in spinal chord injury patients, in patients suffering from full body reflex sympathetic dystrophy, and in general dentistry.
CES and the treatment of pain was last modified: October 16th, 2013 by cesadmin