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Cranial Electrotherapy Stimulation (CES):

Cranial Electrotherapy Stimulation / CES Therapy

CES for pain relief

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CES is very effective for pain relief.   A few documented, responsive chronic pain states are:

✔ Arthritis

✔ Headaches (Kirsh, 2015)

✔ Fibromyalgia.    Fibromyalgia patients with severe chronic headaches, who had failed to respond to biofeedback, low tyramine diet, physical therapy and local injections, were treated with CES. About half of the 75 subjects had a significant reduction in the frequency and intensity of headaches. This study also found an overall decrease in the sensitivity of six main tender points on various body parts; (Taylor et al, 2013; Taylor et al Dec 2013; Cork et al 2004; Lichtbroun et al, 2001; )

✔ Lower back pain  (Zimmerman et al, 1987)

 Spinal cord injury pain  (Tan et al, 2011; Tan et al 2006; Tan et al, 2003)

✔ Reflex sympathetic dystrophy

✔ Temporomandibular joint (TMJ) dysfunction syndrome

✔ Migraine.    CES found to reduce frequency, intensity and duration of migraine headaches. (Brotman, 1989)

✔ Cancer Pain.    In every case there was a positive effect in decreasing pain applying CES treatments to severe intractable cancer pain that failed to achieve relief with heavy medication and surgery (studies conducted by the Division of Otolaryngology, Case Western Reserve University School of Medicine, and the Veterans Administration Medical Center in Cleveland, Ohio) (Yennurajalingam et al, 2017)

✔ Pain in Parkinson's disease   (Rintala et al, 2010)

✔ Miscellaneous chronic pain / pain control  (Brotman et al, 1989; Heffernan et al 1997; Rintal et al, 2010;  Roth et al, 1986; Sizer et al, 2000; Zimmerman et al, 1987; Keizer et al, 2016; Kirsch et al, 2015; Smith 2001; Bauer, 1983; Holubec, 2009; Kulkarni and Smith, 2001; Tae-Kyu Lee et al, 2004; Tan et al, 2010; Yennurajalingam et al, 2017 )

References

www.stress.org

Randomized Controlled Trials

Fibromyalgia:

Cork, Randall C., Wood, Patrick, Ming, Norbert, Shepherd, Clifton, Eddy, James, Price, Larry. (2004)  The Effect of Cranial Electrotherapy Stimulation (CES) on Pain Associated with Fibromyalgia.  The Internet Journal of Anesthesiology, 8(2). pdf

Lichtbroun, Alan S., Raicer, Mei-Ming C., and Smith, Ray B.  (2001) The Treatment of Fibromyalgia with Cranial Electrotherapy Stimulation.  Journal of Clinical Rheumatology, 7(2):72-78. Presented at the Fifteenth Annual International Symposium on Acupuncture and Electro-Therapeutics, Columbia University, New York, October 1999. pdf link

Taylor, Ann Gill, Anderson, Joel G., Riedel, Shannon L., Lewis, Jante E., Kinser, Patricia A., and Bourguignon, Cheryl.  (Dec. 2013) Cranial electrical stimulation improves symptoms and functional status in individuals with fibromyalgia. Pain Management Nursing;14(4):327-335. pdf

Taylor, Ann Gill, Anderson, Joel G., Riedel, Shannon L., Lewis, Janet E. and Bourguignon, Cheryl. (2013) A randomized, controlled, double-blind pilot study of the effects of cranial electrical stimulation on activity in brain pain processing regions in individuals with fibromyalgia.  Explore, 9(1):32-40. pdf

Spinal cord injury:

Tan, Gabriel, Rintala, Diana, Jensen, Mark P., Richards, J. Scott, Holmes, Sally Ann, Parachuri, Rama, Lashgari-Saegh, Shamsi and Price, Larry R. (2011) Efficacy of cranial electrotherapy stimulation for neuropathic pain following spinal cord injury: a multi-site randomized controlled trial with a secondary 6-month open-label phase.  The Journal of Spinal Cord Medicine, 34(3):285-296. pdf

Tan, Gabriel, Rintala, Diana H., Thornby, John, Yang, June, Wade, Walter, and Vasilev, Christine. (April 7, 2006)  Using Cranial Electrotherapy Stimulation to Treat Pain Associated with Spinal Cord Injury.Journal of Rehabilitation Research and Development, 43(4):461-474, 2006. Presented at the South Central VA Health Care Network’s Pain Management Initiative 2nd Annual Pain Management Symposium: Campaign Against Pain. Jackson, Mississippi. pdf 

Tan, G., Rintala, D., Herrington, R., Yang, J., Wade, W., Vasilev, C. and Shanti, B.F. (2003) Treating Spinal Cord Injury Pain With Cranial Electrotherapy Stimulation. Journal of Spinal Cord Medicine, 26(3). Poster presented at the Annual Meeting of the American Paraplegia Society, Las Vegas, Nevada, September 2-4, 2003. pdf Poster

Miscellaneous Chronic Pain:

Brotman, Philip. (1989) Low-intensity transcranial electrostimulation improves the efficacy of thermal biofeedback and quieting reflex training in the treatment of classical migraine headache. American Journal of Electromedicine, 6(5):120-123. Doctoral dissertation, City University Los Angeles, 117 pages, 1986. pdf

Heffernan, Michael. (1997) The Effect of Variable Microcurrents on EEG Spectrum and Pain Control. Canadian Journal of Clinical Medicine, 4(10):4-11. pdf

Rintala, Diana H., Tan, Gabriel, Willson, Pamela , Bryant, Mon S., and Lai, Eugene C. H. (2010) Feasibility of Using Cranial Electrotherapy Stimulation for Pain in Persons with parkinson’s disease.  Parkinson’s Disease. 8 pages. pdf

Roth, Peter M, & Thrash, William J. (1986) Effect of Transcutaneous Electrical Nerve Stimulation for Controlling Pain Associated with Orthodontic Tooth Movement. American Journal of Orthodontics, 90(2):132-138. pdf

Sizer P, Sawyer S, Brismee J, Jones K, Bruce J, Slauterbeck J. (Jun 2000) The Effect of Microcurrent Stimulation on Postoperative Pain After Patellar Tendon-Bone Anterior Cruciate Ligament Reconstruction.  Presented at the American Physical Therapy Association Annual Conference and Exposition, Indianapolis, Indiana.

Zimmerman, Stephen I, & Lerner, Fred N. (June 1989) Biofeedback and Electromedicine Reduce the Cycle of Pain Spasm Pain in Low Back Patients.  Medical Electronics, 117:108-120. Doctoral dissertation (SZ), City University Los Angeles, 284 pages, 1987. pdf

Case Series and Reports

Keizer B, Sposato L, and Yancosek K.  (2016) A Progressive Treatment for a Chronic Progressive Disease: The War Against Complex Regional Pain Syndrome. The Pain Practitioner.  6(1):26-31. pdf

Kirsch DL, Price LR, Nichols F, Marksberry JA and Platoni KT. (2015) Cranial Electrotherapy Stimulation: Treatment of Pain and Headache in Military Population.Practical Pain Management, 15(8):57-64. pdf

Smith, Ray B. (2001) Is Microcurrent Stimulation Effective in Pain Management? An Additional Perspective. American Journal of Pain Management, 11(2):62-66. pdf

Bauer, William. (1983) Electrical Treatment of Severe Head and Neck Cancer Pain. Archives of Otolaryngology, 109(6):382-383. pdf

Open Clinical Trials

Holubec, Jerry T (2009) Cumulative Response From Cranial Electrotherapy Stimulation (CES) for Chronic Pain Practical Pain Management, 9(9):80-83 . pdf

Kulkarni, Arun D. and Smith, Ray B. (2001) The Use of Microcurrent Electrical Therapy and Cranial Electrotherapy Stimulation in Pain Control. Clinical Practice of Alternative Medicine.2(2):99-102. pdf

Tae-Kyu Lee, Kwan-Sung Lee, Shin-Soo Jeun, Young-Kil Hong, Chun-Kun Park, Joon-Ki, Moon-Chan Kim (April 14, 2004) The control of chronic pain using Microcurrent Electrical Therapy and Cranial Electrotherapy Stimulation.  From the Department of Neurosurgery, Kangnam St. Mary’s Hospital, College Of Medicine, and The Catholic University of Korea, Seoul, Korea. Presented at the Korea Society for Stereotactic & Functional Neurosurgery.

Tan, Gabriel, Dao, Tam K., Smith, Donna L., Robinson, Andrew and Jensen, Mark P. (2010) Incorporating Complementary and Alternative Medicine (CAM) Therapies to Expand Psychological Services to Veterans Suffering From Chronic Pain. Psychological Services, 7(3):148–161. pdf

Yennurajalingam S, Kang D-H, Hwu W-J, Padhye NS, Masino C, Dibaj SS, Liu DD, Williams JL, Lu Z, Bruera E. (Sep. 2017) Cranial electrotherapy stimulation for the management of depression, anxiety, sleep disturbance, and pain in patients with advanced cancer: a preliminary study. Journal of Pain and Symptom Management.  E-published ahead of print.

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Pulsed Electromagnetic Field Therapy (PEMFT)

Electrotherapy

       "The medical kit of the future"

The Body Electric

General electrotherapy health benefits.   Used systemically and/or locally at specific problem areas of the body, its effective application has many benefits:

Detoxification Wellness / Healthy aging Pain relief 
Relief from insomnia Immune system restoral Anti-Inflammatory
Maximizes cellular energy production Accelerated tissue /bone /scar healing Stress Reduction
Muscle relaxation / rehabilitation Increased blood oxygen / circulation +++

There are several reasonably affordable electrotherapy devices available for personal use. The following electrotherapies are those that have received a significant amount of positive feedback:

*  Cranial Electrotherapy Stimulation (CES) applies specific frequency patterns to the head area, with the following benefits:

Balances brain neuro-transmitters Relieves pain  Treats depression
Substance abuse withdrawal Relieves insomnia Relieve stress / anxiety
 Anti-Inflammatory Fibromyalgia +++