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The New England Journal of MedicineCutaneous Electroanalgesia for Relief of Chronic and Neuropathic Pain

How might the unique mechanisms of TENS and Scrambler therapy revolutionize the landscape of non-pharmacological interventions in chronic pain management?

As physicians strive to seek innovative, non-pharmacologic interventions for chronic pain, cutaneous electroanalgesia, particularly transcutaneous electrical nerve stimulation (TENS) and Scrambler therapy, presents promising approaches.

Key Points

  • TENS and Scrambler therapy are forms of cutaneous electroanalgesia used for chronic pain management.
  • TENS, although effectiveness is largely based on open-label trials or case series, is valued for its accessibility, safety, and adjustability.
  • Scrambler therapy, a more recent method, requires trained professionals for administration and is believed to work by transforming pain stimuli into nonpainful sensations.
  • Scrambler therapy’s analgesic effects can last for extended periods, needing further investigation for validation.

Additional Points

  • There is a paucity of large, well-designed, randomized, sham-controlled clinical trials for both TENS and Scrambler therapy.
  • Cost and availability might limit the broader application of these therapies, especially Scrambler therapy.


  • TENS and Scrambler therapy hold promise as non-pharmacologic approaches for chronic pain management but require further research to fully comprehend their mechanisms and optimize their use.

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Did You Know?
According to the American Chronic Pain Association, nearly one in three Americans live with chronic pain, more than the combined number affected by heart disease, cancer, and diabetes.

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