results also have been reported for labor, epilepsy,
hypertension, surgery, spinal cord injuries, chronic pain, arthritis,
cerebral atherosclerosis, eczema, dental pain, asthma, ischemic heart
disease, stroke, motion sickness, digestive disorders as well as
various addictive disorders including cocaine, marijuana, heroin and
alcohol abuse (Brovar, 1984; Daulouede, 1980; Feighner, Brown, &
Olivier, 1973; Gomez & Mikhail, 1978; Overcash & Siebenthall, 1989;
Patterson, 1983; Schmitt, Capo, Frazier, & Boren, 1984; Smith, 1975;
Smith, 1982; Wharton, McCoy, & Cofer, 1982).
Reflex sympathetic dystrophy (RSD) and fibromyalgia syndrome (FS) are
two significant pain diagnoses from primary central and autonomic
nervous system etiologies that respond best to CES (Alpher & Kirsch,
1998; Lichtbroun, Racier, & Smith, 1999). Adding somatic treatment
with MET to these two conditions does not seem to improve the
Besides specific pathological disorders, there are a growing number
of studies being conducted that show increases in cognitive
functions. Michael Hutchison (1986) discussed several
mind-enhancement techniques in his book Megabrain, devoting Chapter 9
to CES as a tool for attaining higher levels of consciousness.
Sparked by Hutchison, Madden and Kirsch (1987) completed a study that
demonstrated CES is a useful tool for improving psychomotor
abilities. Smith (1999) demonstrated that CES significantly improved
stress-related cognitive dysfunction, such as attention deficit
disorder (ADD), after only 3 weeks of treatment, and maintained the
effect through an 18-month follow-up assessment.
Cranial electrotherapy stimulation devices are generally similar in
size and appearance to TENS units, but pro-duce very different
waveforms. Standard mA-current TENS devices must never be applied
transcranially. CES electrodes can be placed bitemporally, forehead
to posterior neck, bilaterally in the hollow just anterior to the
mastoid processes, or through electrodes clipped to the earlobes. The
ear clip method, developed by the author, is the easiest and possibly
most effective electrode placement.
The electrodes must first be wet with an appropriate conducting
solution. When using ear clip electrodes, apply them to the superior
aspect of the ear lobes, as close to the jaw as possible. Start with
a low current and gradually increase it. If the current is too high
the patient may experience a painful stinging sensation at the
electrodes, dizziness, or nausea. If any of these three symptoms
arise, immediately reduce the current and the symptoms will subside
in a few moments. After a minute or two, try increasing the current
again, but keep it at a comfortable level. It is okay for the patient
to feel the current as long as it is not uncomfortable.
The ideal treatment time is 20 to 60 minutes, but some patients may
achieve the full benefits of a CES treatment within 10 minutes. Many
dentists use it instead of nitrous oxide gas to help relax patients
during dental procedures (Winick, 1999). Sometimes these dental
procedures last for hours with the patient undergoing CES treatment
the entire time.
Although CES treatment is indicated for insomnia, because of the
increased alertness some patients find it difficult to fall asleep
immediately after a treatment. Accordingly, it is recommended that
CES be used at least 3 hours before going to bed. Also, in most cases
after daily treatments for the first week or two, treating every
other day is usually more effective than daily treatment.
THE CES EXPERIENCE
During the treatment, most patients will experience a subjective
change in body weight. They may feel heavier at first and then
lighter, or they may feel lighter initially. The patient may feel
worse during the heavy cycle and this feeling can last for hours or
even days in rare cases unless extra treatment time is given.
There-fore, it is important to continue the treatment if the patient
feels heavier at the end of the allotted time, even if it has already
been 20 minutes or more. Continue for at least 2 to 5 minutes after
the patient feels lighter. Not all patients will be aware of these
Following CES, most people feel better, less distressed, and more
focused on mental tasks. They generally sleep better and report
improved concentration, increased learning abilities, enhanced
recall, and a heightened state of well-being.
Psychologists first described these general feelings during the 1970s
as an alpha state of consciousness. Meditation, biofeedback training,
relaxation instructions, chanting, hypnotherapy, and certain
religious rituals also produce such states. This is not the same as
the alpha brain wave frequency of 8 to 13 Hz. Often, practitioners
are confused by device representatives who claim that their
particular devices will output and entrain a brain to the alpha
frequency. There is no evidence to support that CES devices work on
an entrainment principle.
There have not been any significant lasting harmful side effects
reported in any of the research literature from either MET or CES. As
with all electrical devices, caution is advised during pregnancy, and
with patients using an older model (pre-1998) demand-type pacemaker.
In addition, it is recommended that patients do not operate complex
machinery or drive automobiles during and shortly after a CES
Microcurrent electrical therapy and cranial electrotherapy
stimulation are electromedical modalities that use low level currents
that usually do not exceed 1 mA. Beneficial effects have been
reported for a wide variety of pain, psychological distress, and
Pain is a complex process encompassing the entire nervous system. To
achieve optimal results through electromedical intervention, the
peripheral and central nervous systems should both be treated.
Cranial electrotherapy stimulation induces a relaxed, alert state. It
is a primary modality effective for controlling anxiety, depression,
insomnia, and generalized stress ubiquitous in pain patients. In
addition, there is mounting evidence that CES can enhance cognitive
functions. Because of its safety and effectiveness, the combination
of MET and CES used with the protocols described here is highly
recommended for a broad range of pain and stress-related disorders.