Hi Kristen,
Wanted to share our scoping review of high quality RCTs assessing
pharmacological and nonpharmacological management of CIPN that was published in
February: https://pubmed.ncbi.nlm.nih.gov/35128938/
The one study that assessed a topical cream (ketamine + amitriptyline) found
that it was not effective. Interestingly, the two RCTs that examined the
effectiveness of scrambler therapy found no significant benefit… I know RCTs
aren’t necessarily the be all end all, but thought this may give some
direction.
Hope this helps. Happy to discuss if you want to reach out.
Steve
On Apr 26, 2022, at 8:59 PM, Kristen <dmarc-noreply@xxxxxxxxxxxxx> wrote:
Thank you for the recommendation for Scrambler Therapy. I'll look into it!
On Tuesday, April 26, 2022, 08:49:41 PM EDT, chitra Srinivasan
<chithrats@xxxxxxxxxxx> wrote:
Recently Scrambler Therapy is FDA approved for CIPN and studies show
promising results. Only some clinics have it as insurances don't cover this
treatment, yet.
How do you bill for dry needling?
C. Srinivasan
On Apr 26, 2022, at 7:42 PM, Kristen <dmarc-noreply@xxxxxxxxxxxxx> wrote:
Hello! We are getting a lot more referrals for CIPN, often after chemo is
already complete and the patient has severe neuropathy. We currently address
balance, strength, sensory normalization techniques (contrast baths, various
textures of fabric), STM, TENS, and in some cases dry needling. Any
recommendations for other modalities or treatments that you have found
successful? Also wondering if there are any topical creams (over the counter
or Rx) that you have found really help.
Unrelated, but I recently had a patient with h/o breast cancer and radiation
fibrosis. Her biggest complaint was breast itchiness ever since her surgery
and only got worse with radiation; the itchiness was mostly under her
incisions but she says the feeling is "deep" and she can never get the itch
to go away. She said she has tried every over the counter ointment and
lotion with nothing helping. We have just started treatment for her
including using non-thermal low level laser for the fibrosis, but wondering
if there is anything else we can do to help specifically with the itchiness?
Last topic...has anyone noticed any correlation with persistent breast
tissue pain after a patient has had COVID? We have seen a couple patients
with persistent breast tissue pain despite all our best interventions. The
physicians are at a loss what to do next and are referring to pain
management. We have even asked about rheumatology consults. The most relief
we have been able to provide these patients is completing MLD and taping for
edema. Just curious what others have observed.
Our oncology rehab group is new-ish (has really grown this past year), so we
are all still learning and would be interested in other specialists' insight
into these topics!
Thank you,
Kristen Knox
