Scrambler Therapy and the Clinical Work of Dr. Jason Cooney

Reframing Chronic Neuropathic Pain Through Non-Invasive Neuromodulation

 

By: Lennard M. Goetze, Ed.D

 

Chronic neuropathic pain remains one of the most difficult clinical challenges in modern medicine. Patients with conditions such as Complex Regional Pain Syndrome (CRPS), chemotherapy-induced peripheral neuropathy (CIPN), and idiopathic neuropathy often cycle through medications, injections, and procedures with limited or short-lived benefit. Within this therapeutic gap, Scrambler Therapy (also known as Calmare® Therapy) has emerged as a non-invasive neuromodulation approach designed to interrupt maladaptive pain signaling and restore functional quality of life.

 

At the forefront of this clinical application in the New York–New Jersey region is Dr. Jason Cooney, DC, Clinical Director at Scrambler Therapy NJ. With more than two decades of experience in chiropractic rehabilitation and physiotherapy, Dr. Cooney has focused his practice on patients whose pain has persisted despite conventional care. Trained by his father, Dr. Michael Cooney, DC—an early adopter and national educator in Calmare Therapy—Dr. Cooney represents a second generation of clinicians committed to advancing non-pharmacologic, evidence-informed pain management.

How Scrambler Therapy Works

Scrambler Therapy is an FDA-cleared medical device designed to treat neuropathic pain by altering how the nervous system encodes pain information. Unlike conventional electrical stimulation used in physical therapy (e.g., TENS), the Scrambler system uses multiple proprietary signal patterns that change continuously during treatment sessions. These variable waveforms are intended to prevent neural adaptation and maintain effective communication with sensory nerve fibers.

 

Electrode pads are placed strategically along dermatomal distributions above and below the region of pain rather than directly on the most painful site. The device transmits non-painful signals primarily through small sensory fibers that project to the spinal cord and onward to higher pain-processing centers. Over repeated sessions, these signals aim to replace persistent “danger” messages with neutral or corrective input, reducing the brain’s tendency to perpetuate a chronic pain loop.

Clinically, the approach is grounded in the understanding that chronic pain is not solely a peripheral tissue problem; it is also a learned neural pattern that can become reinforced over time. By providing consistent, non-threatening sensory input, Scrambler Therapy seeks to recalibrate pain pathways that remain locked in a heightened state of reactivity.

 

Clinical Indications and Limitations

Dr. Cooney reports the strongest outcomes in patients with neuropathic pain syndromes, particularly CRPS and CIPN. These conditions often involve abnormal neuroinflammatory responses and maladaptive sensory processing following injury, surgery, or chemotherapy exposure. In these populations, Scrambler Therapy has demonstrated meaningful reductions in pain intensity for a substantial proportion of patients, often enabling improvements in sleep, mobility, and daily function.

 

However, the therapy is not positioned as a universal solution for all pain. Structural conditions such as severe spinal stenosis, advanced degenerative disease, or mass-occupying lesions fall outside its therapeutic scope. Because Scrambler Therapy does not correct biomechanical compression or tissue destruction, patient selection and diagnostic clarity are essential. Dr. Cooney emphasizes that the therapy is best viewed as a neurofunctional intervention—one that targets dysfunctional signaling rather than structural pathology.

 

Treatment Protocol and Patient Experience

A standard course of Scrambler Therapy typically involves daily sessions over a two-week period, with each visit lasting approximately one hour. Patients do not experience painful stimulation during treatment; instead, they describe mild tingling or tapping sensations. Early sessions may provide only temporary relief lasting hours, but cumulative exposure often extends the duration of symptom reduction. In some cases, patients experience prolonged remission, while others benefit from periodic “booster” sessions to maintain gains.

 

For individuals whose pain has limited activity, the reduction in discomfort can create an opening for functional rehabilitation. Dr. Cooney integrates Scrambler Therapy within a broader care model that includes chiropractic methods, physiotherapy, and movement-based recovery strategies. As pain diminishes, patients are more capable of re-engaging in mobility work and strength conditioning, indirectly supporting muscular recovery that had been hindered by chronic pain.

 

Research Context and Institutional Adoption

While early skepticism often accompanies novel neuromodulation technologies, Scrambler Therapy has gradually gained traction within academic and hospital settings. Clinical evaluations conducted by major medical centers have contributed to growing acceptance of the modality for neuropathic pain syndromes. The device itself was developed in Italy and refined through international clinical collaboration, with training programs disseminated across Europe and the United States.

 

Institutional interest is also expanding within veteran health systems, where neuropathy related to toxic exposures and injury presents a persistent care challenge. This broader uptake reflects a shift toward integrative pain models that prioritize non-opioid, non-surgical interventions when appropriate.

 

A Patient-Centered Clinical Ethos

Dr. Cooney’s clinical identity centers on compassionate, personalized care for patients who have exhausted conventional options. His practice frequently receives referrals from major medical centers, underscoring the role of Scrambler Therapy as a complementary option within multidisciplinary pain management. Beyond individual care, he advocates for responsible education among clinicians, emphasizing that device-based therapies must be applied with neurological understanding and careful patient screening.

 

In an era marked by opioid fatigue and growing awareness of neuroplastic pain mechanisms, Scrambler Therapy represents a targeted attempt to “reset” maladaptive signaling rather than merely suppress symptoms. While not curative for every patient, the approach reflects a broader clinical movement: reframing chronic pain as a modifiable neurobiological process and expanding the toolkit of non-invasive interventions available to clinicians and patients alike.

 

  

PART 2 —

FROM “PAIN” TO THE MEASURABLE:

Why Non-Invasive Energy Therapies Are Reshaping Modern Care

By Dr. Robert Bard, MD, DABR, FAIUM, FASLMS

When I read Dr. Jason Cooney’s account of Scrambler Therapy, what stood out wasn’t only the “wow” stories—though those matter—it was the clinical logic behind why this category of care is expanding. Scrambler Therapy (Calmare®) is part of a broader movement toward non-invasive, energy-based and neuromodulation therapies that aim to reduce symptoms while avoiding the risk, recovery, and downstream complications associated with procedures and long-term drug dependence. In 2026, this isn’t a fringe trend; it’s a practical response to a persistent problem: chronic neuropathic suffering that too often outlives the standard toolbox.

Here’s the pivotal reframing I advocate: we should talk less about pain as a vague sensation and more about inflammation, neural signaling dysfunction, and maladaptive neuroplasticity—because those are closer to what we can evaluate, monitor, and validate. “Pain” is real, but it is also subjective. Inflammation and neurologic dysregulation are the measurable terrain underneath many pain syndromes, especially neuropathic conditions.

Scrambler Therapy exemplifies this shift. The mechanism isn’t about “blocking” discomfort—it’s about modulating the information stream carried by sensory fibers and processed centrally. A phase II randomized trial comparing Scrambler Therapy to TENS in chemotherapy-induced peripheral neuropathy (CIPN) reported better outcomes for Scrambler in that setting, supporting the concept that not all “electrostim” is created equal. Earlier clinical research also suggested Scrambler could outperform guideline-based drug management for certain chronic neuropathic pain states. Reviews describe Scrambler as a non-invasive method intended to reorganize maladaptive pain signaling pathways—exactly the direction modern neuro-therapeutics is heading.

To review, the vast market of non-invasive energy therapies includes:

·        Scrambler Therapy (Calmare®):
A specialized neuromodulation system that delivers continuously varied signal patterns designed to disrupt chronic pain encoding. Unlike fixed waveform TENS, Scrambler’s algorithmic variability aims to prevent nerve adaptation and promote longer-lasting reductions in pain intensity, particularly in neuropathic syndromes such as CRPS and chemotherapy-induced peripheral neuropathy.

· Pulsed Electromagnetic Field (PEMF) Therapy:
PEMF applies pulsating magnetic fields to tissues to influence cellular behavior. Research suggests potential benefits in pain reduction, improved blood flow, and reduced inflammation for conditions ranging from osteoarthritis to soft-tissue injury. Because it affects tissues at the cellular level, PEMF is frequently integrated into rehabilitation and chronic pain clinics.

·        Shockwave Therapy:
Shockwave uses focused high-amplitude acoustic waves to deliver mechanical energy deep into musculoskeletal tissues. Originally developed for urology, therapeutic shockwave promotes neovascularization, cellular regeneration, collagen remodeling, and reduction of chronic inflammation in tendon, ligament, and muscle structures. Clinically, it has shown efficacy for plantar fasciitis, Achilles tendinopathy, and chronic myofascial pain syndromes. Shockwave is non-invasive, typically requires only a few outpatient sessions, and often leads to measurable functional gains.

·       Photobiomodulation (Low-Level Laser / Red Light Therapy): Light at specific wavelengths can penetrate into tissues, triggering biochemical cascades that reduce oxidative stress and inflammatory mediators. Studies have reported reductions in joint pain, improved tissue healing rates, and improved outcomes in soft-tissue injury.

·        High-Intensity Focused Electromagnetic (HIFEM) and Radiofrequency Devices:
These platforms use electrical or thermal energy to stimulate deep tissues, sometimes with neuromuscular engagement. While originally developed for aesthetic or muscle-toning purposes, some applications show promise in rehabilitative and pain-related contexts due to improved circulation and neuromuscular normalization.

·        Ultrasound-Guided Neuromodulation:
A growing frontier, using focused ultrasound waves to target deep nervous structures and modulate pain pathways with precision. Clinical trials are underway exploring applications in chronic back pain, peripheral neuropathy, and even central neuromodulation.

·        TENS (Transcutaneous Electrical Nerve Stimulation): Large evidence syntheses report moderate-certainty evidence that pain intensity is lower during or immediately after TENS compared with placebo, with a strong safety profile. In neuropathic pain specifically, recent meta-analytic work suggests TENS may reduce pain to a modest degree, with evidence quality varying by condition and study design.

Why is the trend accelerating? Because many pharmacologic options for neuropathic pain deliver only modest efficacy across heterogeneous patient populations, leaving clinicians and patients searching for better pathways. Non-invasive energy therapies offer a rational alternative: reduce symptom load, calm the nervous system, and restore function—often without adding systemic side effects.

My position is simple: non-invasive matters because it lowers barriers to care, reduces cumulative risk, and invites objective monitoring. The future belongs to therapies that are not only effective, but verifiable. That means pairing these interventions with measurable endpoints—functional testing, neurovascular assessment, imaging-guided monitoring, and physiologic biomarkers—so we can show what is changing, not just hear that it “feels better.”

That’s the real promise here: a new standard where chronic “pain” is approached as a treatable, trackable neuro-inflammatory condition—and where the best technologies win because they can demonstrate outcomes, not because they make the loudest claims.

 

References:

American Academy of Neurology. (2019). A comprehensive algorithm for the management of neuropathic pain: Best practice recommendations. Pain Medicine. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6544553/ — This guideline article reviews evidence-based approaches for neuropathic pain and contextualizes treatment strategies spanning pharmacologic and neuromodulation therapies.

Dworkin, R. H., Backonja, M., Rowbotham, M. C., Allen, R. R., Argoff, C. R., Bennett, G. J., … Wallace, M. S. (2003). Advances in neuropathic pain: Diagnosis, mechanisms, and treatment recommendations. Archives of Neurology, 60(11), 1524–1534. https://doi.org/10.1001/archneur.60.11.1524 — A foundational overview of neuropathic pain mechanisms and clinical management strategies, widely referenced in clinical pain literature.

Mayo Clinic. (n.d.). Peripheral neuropathy: Diagnosis and treatment. Retrieved from https://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/diagnosis-treatment/drc-20352067 — Mayo Clinic describes Scrambler Therapy as an option that uses electrical impulses to send non-painful signals to the brain, aiming to retrain pain perception.

Mayo Clinic. (n.d.). Scrambler Therapy in treating pain and peripheral neuropathy in patients previously treated with chemotherapy [Clinical trial summary]. Retrieved from https://www.mayo.edu/research/clinical-trials/cls-20116107 — Details a clinical trial evaluating Scrambler Therapy for chemotherapy-induced peripheral neuropathy.

Mayo Clinic. (n.d.). A study comparing Scrambler Therapy versus TENS therapy in treating patients with chemotherapy-induced peripheral neuropathy. Retrieved from https://www.mayo.edu/research/clinical-trials/cls-20199631 — This randomized clinical trial compares Scrambler Therapy with conventional TENS therapy for neuropathy symptoms.

Marineo, G. (2016). Scrambler Therapy for the management of chronic pain. Pain Management, 6(2), 12–20. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4973603/ — A review of Scrambler Therapy mechanisms and early clinical evidence supporting its use in chronic pain syndromes.

National Cancer Institute. (n.d.). Chemotherapy-induced peripheral neuropathy. Retrieved from https://en.wikipedia.org/wiki/Chemotherapy-induced_peripheral_neuropathy — Overview of CIPN’s clinical impact and prevalence among patients receiving chemotherapeutic agents.

 

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