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The pain that left him bedridden is finally easing

Scrambler therapy has helped Thomas Barry quit taking some medications he relied on for years

Carol Hipple and Thomas Barry
Nurse Carol Hipple adjusts the scrambler therapy device as she treats Thomas Barry in her clinic in the MUSC Hollings Cancer Center. While the therapy is used for some cancer patients, it's also used for people such as Barry whose pain is unrelated to cancer treatment.   Photo by Sarah Pack
Helen Adams | adamshel@musc.edu | October 8, 2018

Thomas Barry hopes to do a lot more sightseeing and a lot less lying in bed on his family trip to Italy this year. During last year’s trip, “It was pretty bad,” he says. Thanks to chronic pain, “I was Mr. Grumpy. Eeyore.”

He’s much happier since starting treatment at MUSC Health using a device called the scrambler. “I was fully disabled. Now, I’ve gotten my life back.”
 
Scrambler therapy arrived at MUSC Health last year and was an immediate hit. People across South Carolina and beyond who were suffering from long-term pain wanted to give it a try. It was a reminder of how common chronic pain is. About 25 million American adults have chronic pain, according to an analysis by the National Institutes of Health. Almost 40 million have severe pain. 
 
The scrambler clinic was in high demand. It’s still busy, but it has openings again and is accepting new patients. Barry became one of them in August.
 
“So let’s move this up a little bit more,” nurse Carol Hipple says as she adjusts the electrodes she’s placing on Barry’s feet during an appointment. “We’re close, I think. I like that heel location.”
 
“It’s stinging on the top,” Barry tells the scrambler specialist. 
 
“Is it a prickly sting?”
 
“Prickly,” he agrees.
 
“OK, let’s see if we can get past it,” Hipple says. She keeps adjusting until Barry feels a buzzing or humming sensation, which tells her the electrode is in the right place.
 
Scrambler therapy is used as a treatment for chronic nerve pain that hasn’t gotten better with more traditional options such as medication and physical therapy. Hipple says the scrambler device transmits “no pain” messages to nerves through electrodes on the patient’s skin, overriding the “pain” messages.
 
That may sound a little far-fetched, but studies suggest it really works for some people. One scrambler researcher, Pat Coyne, works at the Medical University of South Carolina. He’s a clinical nurse specialist who’s been involved in multiple studies looking at the safety and effectiveness of scrambler therapy. 
 
Coyne was recently part of a team that did a double-blinded, randomized, sham-controlled study testing the scrambler on people with lower back pain. That type of study is considered the gold standard because neither the investigators nor the patients know who’s getting the real treatment and who’s getting a placebo. 
 
They found scrambler therapy significantly decreased pain and pain sensitivity. The National Institute of Nursing Research at the National Institutes of Health funded the study. 
 
Scrambler therapy has also been studied as a way to reduce the pain that can come with chemotherapy in people with cancer. A July 2018 report in the journal Pediatric Blood Cancer found it significantly lowered patients’ pain levels.
 
Since so many people who have chemotherapy have pain as a side effect, the scrambler device at MUSC Health sits in Hollings Cancer Center. But is used for people with other types of pain as well. Barry’s pain is idiopathic. That means doctors don’t know what caused it. 
 
“It started gradually in 2007,” he says. “In the balls of my feet and the arch. On Thanksgiving I couldn’t walk. We went on vacation to Key West and by the end of the week I could barely walk — it was that bad.”
 
His family doctor in Simpsonville, near Greenville, South Carolina, sent him to a neurologist. “They put me on gabapentin and it would get worse and worse.”
 
He had to quit working as an electrical engineer in 2010 because the pain had moved to his hands as well. 
 
“I started taking higher and higher doses of medicine. I started with the opioids in 2012. I’ve been on those, different ones, ever since.” He’s also tried acupuncture, infrared heat therapy, changes in diet and transcutaneous electrical nerve stimulation (TENS) therapy. “Nothing would work.”
 
He and his wife heard about scrambler therapy from friends at church and got in touch with MUSC Health. They met Hipple, who told them scrambler therapy isn’t a cure but can help people manage pain and has an 80 percent success rate. It is usually not covered by insurance. 
 
Barry was skeptical but hopeful. “I was in bad shape. I was fully disabled.”
 
He started treatment in August, which involved a series of ten 30 to 45 minute sessions with Hipple. “I was a little discouraged at times, but by the last two days I could tell it was working,” Barry says. “I had a 50 percent pain reduction.”
 
He can now walk about three-quarters of a mile and looks forward to getting a better look around Italy this time. He’ll take it easy, but he won’t be tied to his hotel room. “It’s amazing.”

MUSC launches state's only chronic pain rehab program (MUSC Catalyst News, April 19, 2018) 

MUSC researchers want to know if brain stimulation can treat chronic pain without medication (The Post and Courier, Nov. 5, 2017)

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