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%.
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.
From JCR: Journal of Clinical Rheumatology: April 2001 – Volume 7 – Issue 2 – pp 72-78
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.
More dramatically, following the terrorists’ bombing of New York skyscrapers and the Pentagon in Washington, D.C., it was found that the level of pain in chronic pain patients being treated in three widely dispersed sites in the U.S. increased 17% in male patients and 47% in female patients when the bombing occurred between pain clinic visits. Subsequent visits to the same pain clinics showed that there was a lag in pain response to treatment following that stressful event, with men improving only 3% on subsequent treatment visits and women still suffering 34% more pain on subsequent treatment visits than they did prior to the stressful event. (The authors noted that females are known to respond more dramatically to stress related pain, such as in the post traumatic stress disorder (PTSD), than do males.)