SCRAMBLER THERAPY FOR THE TREATMENT OF FIBROMYALGIA: A TRADITIONAL METHOD FOR A NOVEL THERAPEUTIC APPROACH: C.M. Spinello, G. Palmeri, E. Cascino, C. Spinello | Hospice-Terapia del Dolore-Cure Palliative P.O."Vittorio Emanuele" Gela ASP CL, Italy

Introduction. Fibromyalgia (FM) is a chronic condition characterized by widespread nociplastic pain (that required at least 11/18 painful tender points), fatigue, sleep disturbance and mood symptoms (1). Current guidelines recommend antidepressant (i.e. serotonin-norepinephrine reuptake inhibitors) and anticonvulsant medications (gabapentin/pregabalin) that provide only moderate relief (2). Studies support the recommendation of a multimodal approach to treatment FM involving individualized evidence-based pharmacotherapy and nonpharmacologic treatments (3). In our study, we treated 20 patients with FM, from 2023 to 2026, using Scrambler Therapy (ST), a neurocutaneous stimulation method that delivers non-painful stimuli through surface electrodes. It does not block painful information, but replaces it with compatible, non-painful information (4). The objective of our observational clinical study was to evaluate the analgesic efficacy of ST in patients with FM.Methods. Twenty patients were enrolled in the study: 15 women and 5 men, from 2023 to 2026, aged between 40 and 60, with a diagnosis of FM. Exclusion criteria were: age 60 years, regular opioid use, sessions non completed. The symptoms presented by the patients were widespread pain in the body associated with tender points at shoulder, back and hip regions. The patients had been treated by different specialists, a wide variety of pharmacologic drugs (i.e.Tapentadol 50 mg twice daily) and dietary supplements(Acetylcarnitine 500 mg three times a day) had been used with limited success in treating pain. Despite pharmacological therapy, the patients came to us with NRS: 7-8. All patients were informed about the use of Scrambler Therapy and its mechanism of action. After obtaining informed consent, the therapeutic approach included 10 Scrambler Therapy sessions of 50 minutes each for all 20 patients.Results. All patients who underwent Scrambler Therapy reported improvement in their pain symptoms. Pain measured by NRS at the end of treatment was 2-3 in 16 of 20 patients. The remaining 4 patients (2 women and 2 men) had residual pain with an NRS: 5. They underwent a further cycle of 50-minute Scrambler Therapy for other 10 sessions, with significant improvement in symptoms and a final NRS of 2.Conclusion. In our study, all 20 patients presented with a final NRS of 2-3, 16 of them after 10 50-minute Scrambler sessions and 4 patients after 20 sessions. Scrambler Therapy represents an effective treatment option for patients with FM. More studies are needed to confirm the efficacy of ST in FM.