Participants will work with the provider to decide which method of treatment they prefer
and will then be followed regularly using standardized pain scores over the next year.
Those undergoing ST will undergo 5-10 sessions while those treated with medical therapy
will undergo titration of medication as per typical standard of care. The investigators
will compare both maximal pain relief achieved and duration achieved between groups.
prospectively enroll a consecutive series of patients presenting to clinic with
post-stroke pain syndromes following either an ischemic infarct or intracranial
hemorrhage. Patients will be included in the study if they are at least one month
post-stroke (but can be chronic) and have pain in an area attributable to the location of
their lesion (ie contralateral to a lesion involving the thalamus or sensory cortex). At
their clinic visit, potential treatments: Scrambler Therapy or pharmacological treatment,
will be discussed with each patient. Patients will not be excluded if they are currently
taking or have taken pain medications in the past, though these variables will be
factored into the analysis. Through shared decision making, the investigator along with
the patients input will decide on ST versus medical management. Participants will consent
to being followed for pain control over the following year of therapy to enable
comparison of ST to standard medical therapy.
All patients will begin by rating their current pain on the Numerical Rating Scale (NRS)
from 0-10.
Patients undergoing treatment by Scrambler Therapy will begin by describing the areas and
levels of pain along the Numerical Rating Scale (NRS) from 0-10. The dermatomes of the
areas of pain will be examined by going up and down the dermatome as shown on a dermatome
map, and the electrode of the Scrambler machine will be placed at the site where pain is
initiated and approximately 10 centimeters above it. The Scrambler machine will then be
started and turned on until patients feel a "tingling" sensation that is not painful. For
approximately 45 minutes, the Scrambler machine will run while a team member watches over
the patient, adjusting the levels only if the patient no longer feels the tingling
sensation.
After the Scrambler treatment, patients will again be asked to describe the areas and
levels of pain using the NRS. Each patient undergoing Scrambler Therapy will undergo this
process for 5 consecutive days, following the same procedure every day of treatment.
After completion of treatment, participants will be asked to complete monthly ratings of
their pain for three months, and to follow-up in clinic at 3-6 month intervals (standard
of care).