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The Use of Microcurrent Electrical Therapy and Cranial
Electrotherapy Stimulation in Pain Control

Arun D. Kulkarni, MD, Ray B. Smith, PhD
Clinical Practice of Alternative Medicine. Volume 2, Number 2, Summer 2001

ABSTRACT: The use of cranial electrotherapy stimulation (CES) in pain management is new to the pain field and only recently has begun being documented in US clinical literature. While we are familiar with transcutaneous electrical nerve stimulation (TENS), we were told that microcurrent electrical therapy (MET) and CES were an entirely different approach to pain management. In this open clinical study, we evaluated this potential new treatment combination to assess its effectiveness with our patients who had been refractory to previous treatments. The treatments were scheduled for 1 hour/day, 5 days a week, for 3 weeks. Although 3 patients out of 20 obtained no relief from this treatment, 6 obtained complete relief, and an additional 8 patients received significant relief of 33% to 94%. We conclude that CES and MET are effective treatments for chronic pain patients.

The purpose of the present study was to assess the effectiveness of microcurrent electrical therapy and cranial electrotherapy stimulation separately or together to effect a significant treatment response in chronic pain patients.
Cranial electrotherapy stimulation (CES) is an FDA-accepted treatment for depression, anxiety, and insomnia. A recent review article reported that it has also been effectively used to treat various pain syndromes such as chronic spinal pain, headaches, dental pain, and fibromyalgia. It reportedly also potentiated anesthetics used in general surgery up to 37% when applied during surgery, thus requiring significantly less medication to keep the patient anesthetized.1
CES involves the use of low-level electrical stimulation across the head. In worldwide research over more than 30 years, it has been shown to be effective as a drug-free treatment of anxiety, depression, and insomnia.2 Its mechanism of action is widely thought to be its ability to bring neurotransmitters in stressed subjects back into normal, prestress levels of homeostasis 3.5
That alone could account for any effect it might have on pain perception in chronic pain patients. Schusterb states, for example, "Patients' psychological states influence their perceptions of pain; anxiety can decrease patients' pain thresholds. Increased anxiety . . . can increase pain."
On the other hand, there is new interest in what is now called the pain neuromatrix, located in the cerebral cortex, with connections throughout much of the brain.' The neuromatrix theory was developed from studies of phantom limb pain in amputees. It is believed that this
center is responsible for firing pain messages into various parts of the body, even in the absence of bodily pathology, and may account for much chronic pain for which a cause cannot be found and whose treatment response remains refractory. While it is known that the electrical pulses from CES pass through this area of the brain, among others,8 there is presently no knowledge of how it may interact with this area of the brain to change the pain signaling process, if in fact it does.
Microcurrent electrical therapy (MET) is usually provided directly to the body of the pain patient, either via hand-held probe electrodes or self-adhesive electrodes. Unlike TENS, which is thought to close the spinal gate to pain impulses so that they will not ascend to the brain,9 MET is thought to have a strong anabolic, healing response, with up to 500% increase of ATP into the treated area following a treatment of 1 hour or less, increased movement of amino acids into the area, and an increase in protein synthesis at the site treated.10
One neurosurgeon has reported using CES alone to effectively reduce or eliminate pain in 28 chronic spinal pain patients, obviating surgery in many.11 We decided to follow his CES protocol, plus the protocol provided in a MET device manual, to learn what the combination effect of these 2 reportedly effective treatments would be for our patients.
It should be noted that the MET probe electrodes used in this study were formerly used by pain therapists, and are still often used, on acupuncture points as a modified form of electroacupuncture. Even though there are strong theoretical reasons for such use, acupuncture

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Clinical Practice of Alternative Medicine • Volume 2 • Number 2 • Summer 2001

Used with permission of Electromedical Products International, Inc.

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The Use of Microcurrent Electrical Therapy and Cranial Electrotherapy Stimulation in Pain Control