Scrambler Therapy for Chronic Pain

How Does Scrambler Work?

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The Scrambler Therapy device produces very small electrical currents that are transmitted into the skin via disposable EKG electrodes placed around (but not on) the painful area. The Scrambler signal is thought to provide “non-pain” information to nerve fibers that have been receiving “pain” messages, reducing the patients experience of pain.

Photo by Joshua Sudock

What Kinds of Pain Problems Does Scrambler Treat?

• Chemotherapy-induced Peripheral Neuropathy (CIPN)
• Chronic Cancer Pain
• Phantom Limb Syndrome
• Postherpetic Neuralgia (PHN)
• Post-surgical Neuropathic Pain
• Brachial Plexus Neuropathy
• Other Kinds of Chronic Neuropathic Pain

What are the Limits of Scrambler Therapy?

Scrambler therapy cannot cure or correct the underlying condition that is causing the pain. It treats chronic neuropathic pain as a separate and distinct problem by changing the message the nerves are sending to the brain from “pain” to “non-pain”.

Scrambler is also unlikely to eradicate pain permanently. Most pain will return at some point, but patients can get relief that lasts for months or longer. That time frame may vary based on the individuals response to therapy. When pain reoccurs, we can then provide booster therapy. This treatment is usually 2-3 additional sessions to regain previously experienced pain reductions.

Are There Contraindications to Scrambler Therapy?

Yes. See below:

1. An implanted cardiac pacemaker, spinal cord stimulator or other implanted electronic/programmable devices.
2. Someone who is pregnant or might be pregnant.
3. Someone with a history of seizures/epilepsy or symptomatic brain metastases from cancer.
4. Someone in active withdrawal from drugs or alcohol.
5. Orthopedic hardware (screws, plates, artificial joints) and non-conductive (titanium) implants are generally allowable with Scrambler. “MRI safe” hardware is considered Scrambler safe.
6. Scrambler effectiveness may be reduced in patients taking anticonvulsants, ketamine, or muscle relaxants. If that is the case, please discuss with the treating Scrambler physician.
7. Chemotherapy-induced peripheral neuropathy (CIPN) is highly treatable with Scrambler, but responds BEST if at least two months have passed since the last chemotherapy cycle. The Scrambler physician will assess this issue at the time of clinical consultation.

How Does Scrambler Therapy Feel?

Initially, the patient may feel a very mild pinch/bite/prickly sensation. As the intensity of the stimulation is gradually increased, this changes to a vibration/buzz/hum/pulsing sensation.

The patient sites comfortably in a chair. The treatment is not painful. Pain relief is expected during the first and all subsequent sessions of Scrambler and is an important way for the practitioner to determine appropriate placement of the electrodes.

If there is significant discomfort at any time during a Scrambler treatment session the practitioner will turn the device off and reposition the sticky electrode.

How Long Does Scrambler Therapy Take?

Initial scrambler therapy is usually involves a total of 10 daily sessions given several days per week. As the benefits take hold, the pain relieving effects of Scrambler last longer and longer between sessions.

Some individuals may need fewer than 10 sessions and some may need more than 10 sessions, depending on the response to treatments. A course of Scrambler treatment is considered complete when pain relief lasts a full 24 hours or longer after a session.

Each session lasts 35-45 minutes on the machines once electrodes are placed.

Appointments are scheduled for about an hour.

Photo by Joshua Sudock

Where Does Scrambler Therapy Fit into an Overall Pain Management Program?

We expect that Scrambler may make a significant difference for may patients with chronic pain, but it is not a substitute for continued longitudinal pain care and a relationship with a provider. Patients will remain under the care of their primary care physicians and/or pain management specialists while undergoing Scrambler treatment. We will work with patients’ pain management team to integrate Scrambler therapy into their ongoing pain management plan.

Is Scrambler Therapy Covered by Insurance?

Although Scrambler has been FDA-approved since 2009 as safe and effective for use in the U.S., it is still regarded by regulators and payors as investigational. Therefore, it is not covered by Medicare or most commercial insurance companies. At UCLA, the Scrambler procedure charge is $287.00/session, with no expectation of insurer coverage. You will be required to pay the procedure charge at the time of each service. If your insurer pays some amount on the bill for the Scrambler procedure, UCLA will reimburse you that amount upon receiving payment from the insurer. Both Medicare and commercial insurers generally DO pay for the separate physician professional fees; for these services, you are only responsible for co-pays, per your insurance policy.

How Do I Find Out More or Make/Get a Referral?

Scrambler therapy is being provided on a consultation basis in the UCLA Semel Institute Neuromodulation Division TMS Clinic.

Referring clinicians and their patients can call 310-825-4612 or email [email protected] for more information. The Neuromodulation Division’s website will soon have Scrambler information posted there as well: https://tms.ucla.edu

Referral Form
Referral Instructions: UCLA Provider