Noxipoint Therapy Versus Standard Physical Therapy Using Electrical Stimulation for Chronic Pain
Condition: Shoulder Pain; Neck Pain
MeSH terms: Shoulder Pain; Chronic Pain; Neck Pain
Study type: Interventional

Summary: 
      The purpose of this study is to validate the efficacy of Noxipoint(TM) therapy on chronic
      pain, and compare it with standard physical therapy using electrical stimulation on patients
      with chronic pain.

      Invented by Dr. Charlie Koo at Stanford University, Noxipoint Therapy is a specific procedure
      with precise location, duration and intensity of TENS stimulation within the general FDA
      guidelines. The therapy substantially relieves general muscular/tendon pain and persistently
      restores the muscle and tendon function. The surface locations of nociceptors at the free
      nerve ending (i.e., "Noxipoints") are focused on in the stimulation therapy. Multiple
      clinical uses of Noxipoint Therapy confirmed the consistent efficacy of such stimulation at
      Noxipoints. An observational study of Noxipoint therapy within the FDA-approved use of TENS
      demonstrated an encouraging 93% success rate in eliminating the chronic pain, such as frozen
      shoulder pain, within 2-3 sessions. It is an order-of-magnitude improvement over the
      non-specific application of TENS and any other modalities in pain treatment. A unique
      neuro-immuno-signaling pathway that implicates the activation of adult stem cells, such as
      satellite cells in muscles, is implicated based on such a high success rate.
    

Detailed description: 
      View http://paincurecenter.com/Clinical_Outcome.html for the observational study mentioned in
      the Brief Summary above. For more detailed cases, please view
      http://paincurecenter.com/uploads/Nocipoint_therapy_clinical_study_w_o_ID_2011-2012.pdf
    

Intervention name(s): Noxipoint Therapy; Physical Therapy
Intervention type(s): Procedure; Procedure
Intervention description(s): Patients will be treated with a TENS device, following Noxipoint Therapy guidelines:
Find the cause of the pain via Noxipoint: For each injured muscle/tissue, it is discovered that there are always a pair of points at the skin surface locations of its nociceptors that are painful at light press (named "Noxipoints").
Stimulate the corresponding pair of Nocipoints following a narrowly defined combination of intensity/ frequency (inducing the C-fiber response) and duration (about 1.5-3 minutes) of TENS at the two targeted Noxipoints.
Repeat (a) to (b) above for each identified injured muscle group until all pain areas are eliminated or when the session time is up.
Instruct the subject not to use the newly recovered muscle/tissue too much an estimated rest period depending on his/her age.; The 1.5-hour physical therapy in the control arm are provided both as standard of care and sham device comparison to Nocipoint Therapy, following these guidelines:
TENS stimulation (45 minutes):
• Electrodes will be placed around the patient-identified general pain area on the neck /shoulder for TENS. Rotate the electrode pads around the pain area and stimulate again.
Other modalities of PT per the therapist's choice:
Infrared treatment on the pain areas (about 15 minutes)
Manual therapy to cervical and/or rotator cuff areas (about 15 minutes).
Exercise and training:
Neck exercises: Range of motion exercises to include foraminal opening for about 15 minutes, and/or
Shoulder exercise: Range of motion exercises to include walking the arm on the wall, rotation of the upper arm for about 15 minutes
Hot/cold pack to the pain area for about 15 minutes
Other intervention name(s): Koo's Pain Cure Therapy; PT
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Cervical pain; Cervicalgia,; Cervicodynia; Neck ache; Neckache; Shoulder pain; Shoulder impingement syndrome