• Salahadin Abdi, Matthew Chung, and Giuseppe Marineo.
• Division of Anesthesia, Critical Care and Pain Medicine, Department of Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
• Curr Opin Anaesthesiol. 2021 Dec 1; 34 (6): 768773768-773.

Purpose Of ReviewTherapeutic methods for neuropathic are limited; available drugs can be inadequate or have adverse effects that compromise quality of life. Interest has grown in alternatives to pharmacologic therapy for neuropathic pain. We present a focused review of the literature about the relatively novel noninvasive, nonpharmacologic electrocutaneous nerve stimulation technique called scrambler therapy for treating noncancer neuropathic pain.Recent FindingsNeuromodulation techniques targeting peripheral sites have changed rapidly in recent years. Several clinical studies have demonstrated the analgesic effect of scrambler therapy after 10 sessions of treatment for various types of pain. Although scrambler therapy was originally used for cancer pain, its indications have broadened to postoperative pain, chemotherapy-induced peripheral neuropathy, postherpetic neuralgia, low back pain, diabetic neuropathy, complex regional pain syndrome and central pain syndrome. That said, some of the studies are controversial owing to their small sample size, lack of appropriate scrambler therapy protocol and possible lack of experience of the operators.SummaryWe present the historical perspective, mechanism of action and trial outcomes of scrambler therapy, representing an avenue for managing neuropathic pain without drugs. Well designed phase II/III clinical trials must be conducted to confirm the positive findings reported using scrambler therapy technology. If validated, scrambler therapy could be a game changer.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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