Percutaneous electrical nerve stimulation (PENS), “produced significant acute pain relief,” according to researchers at the University of Texas Southwestern Medical Center at Dallas. Their findings are published in the December issue of The Clinical Journal of Pain.

As it progresses, some cancers spread to involve bone. These ‘bone metastases’ can trigger a form of severe chronic pain that is often unresponsive to analgesic drugs, including morphine.

Searching for alternatives, the Texas researchers focused on PENS. This technique involves the insertion of acupuncture-like needles into the soft tissue surrounding affected bones. PENS therapists then pass a small electric current through these needles, stimulating local nerves. Experts believe this electrical stimulation disrupts normal pain signaling.

In their report, the investigators detail the cases of three patients treated with PENS.

In the first case, a 76-year-old patient with prostate cancer and spinal metastases had “worsening low back pain in spite of escalating doses of oral morphine.” After 30 minutes of stimulation at 15- and 30 Hertz (Hz), “the patient reported a significant reduction in his pain… lasting for approximately 36 hours,” the authors report.

They add that a subsequent 30-minute treatment, set at 100 Hz, reduced pain to a “‘tolerable level’ for 3 to 4 days.”

In the second case, a 51-year-old man with bone involvement due to rectal cancer received 100-Hz treatments once per week. According to the researchers, PENS therapy “allowed him to maintain his pain at a tolerable level… with only occasional use of an oral (analgesic).”

PENS may not be helpful for all cancer patients, however. According to the authors, the therapy “failed to provide any significant relief” to a third patient diagnosed with gallbladder cancer without bony involvement.

At present, the Texas researchers support the use of PENS as a supplement to — but not a substitute for — available analgesic drugs.

“In the future,” they conclude, “larger scale… studies are needed to evaluate the role of PENS as a complementary therapy to analgesic medications in the management of cancer-related pain.”

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