*This is an article from the Summer 2023 issue of Contentment Magazine.
By Dr. Josh Briley, PhD, BCMAS, FAIS
There is a connection between chronic pain and chronic stress, and there are a variety of ways in which chronic pain contributes to chronic stress, and vice versa. Methods for treating chronic pain often overlook the accompanying stress. The result is an incomplete treatment approach that does not provide complete relief for chronic pain patients. This article briefly explores the escalating cycle between chronic pain and chronic stress and how, if unaddressed, often results in anxiety and insomnia that further impact the patient’s life. In addition, this article provides a review of an evidenced-based medical device that can be administered by a practitioner, as well as, by a patient at home that simultaneously relieves pain and treats anxiety and insomnia. Included is a presentation of scientific evidence, along with case based examples of patients treated by this author.
The Cycle of Chronic Pain and Chronic Stress
Patients struggling with chronic pain often experience stress about the cause of the pain, whether a result of an injury or a medical condition. Chronic pain is rarely consistent or predictable from day to day. As any chronic pain patient is aware, there are “good pain days” and “bad pain days.” There are also times when pain may escalate because of a seemingly innocuous movement, a change in the weather, or for no identifiable reason. This vacillation in pain severity contributes to a sense of a lack of control over one’s own body and ability to function. Thus, a chronic pain patient will often experience stress that a “bad pain day” will extend into weeks, months, or even years without significant pain relief. Even on a “good pain day,” when pain is lower than normal, the patient can experience stress related to how long the relief will last.
Pain also has a negative impact on the patient’s daily life and the lives of loved ones. Range of motion, stamina, and functional strength are all reduced for someone struggling with pain, causing them to rely more on loved ones to accomplish tasks they could once readily do without assistance. Therefore, in addition to the loss of a sense of control, a patient with chronic pain often experiences a loss of a sense of independence. Being unable to care for themselves and seeing themselves as a burden to loved ones who care for them contributes to stress and frustration.
Chronic pain patients often limit their physical activity because of the pain, or to avoid further exacerbating their pain. As has been explored in previous Contentment issues, movement, especially light exercise, is an excellent means of not only improving physical mobility and health but is also an effective method of reducing chronic stress. Conversely, lack of physical activity and movement often contributes to increases in stress.
Oftentimes, chronic pain also interferes with the ability to achieve quality, restful sleep. Sleep is essential for both physical and mental health, and over time, the cumulative effects of poor sleep related to chronic pain further compounds the chronic mental and physical stress the patient with pain frequently experiences. Inadequate quality of sleep increases the emotional stress and physical pain the patient experiences. 
Neurologically, pain, anxiety, and insomnia have an impact on the default mode network (DMN). The DMN is a network of nerve pathways in the brain that involves many areas of the brain and is most active when we are relaxed and not focused externally. The combination of chronic pain, sleep deprivation, and stress contributes to disruptions in the electrical activity of the DMN. As a result, pain is perceived as being more profound than can be explained by the physical or medical causes of the pain. This escalation in the perceived amount of pain worsens the sleep disturbance and stress described above, which in turn can escalate the perception of pain. The relationship between these conditions creates a cycle in which the pain exacerbates existing distress, which in turn exacerbates the pain. This ever-increasing cycle contributes to the comorbid conditions that often accompany chronic pain, namely anxiety and insomnia. Thus, to obtain relief from chronic pain as well as relief from the comorbid anxiety and insomnia, it is important that pain treatments focus not just on the physical pain, but also address the neurological effects of this pain.
Most traditional pain treatments, such as medications, do not address the psychological impact of the pain. Medications may attempt to dull the pain sensation or activate nerve cell receptors that block the sensation of pain. However, to improve sleep and reduce the anxiety that is frequently comorbid with chronic pain, additional medications for sleep and mood or anxiety are often prescribed. The result is a cocktail of medications, all with their own adverse effects, which may also have interaction effects with each other. Additionally, some or all these medications can be addictive, or a patient can develop a tolerance to the medication, requiring more to attempt to achieve the same level of relief.
In recent years, the use of neurostimulators to relieve pain has grown in both popularity and effectiveness. These neurostimulators are medical devices that are designed to provide pain relief. Some are designed solely for use in a provider’s office, while others can be used by the patient at home. Depending on the specific device and technology utilized, the safety and effectiveness of these devices vary greatly. However, as with medication, they all share the limitation of solely treating the patient’s pain and do not directly address the comorbid anxiety and insomnia.
A Brief Explanation of the Alpha-Stim®
Fortunately, there is a safe and effective treatment option that not only relieves pain in the body, at the source, but also addresses the psychological aspects of pain by treating the central nervous system and normalizing the electrical activity in the brain (Qiao et al., 2015) especially within the default mode network (Fuesner et al., 2012; Taylor et al., 2013). This normalization is obtained using low amplitude electrical current and a patented waveform. Thus, with a single, easy to use device, a patient can receive a complete treatment for their pain, anxiety, and insomnia.
This treatment option is the Alpha-Stim, a handheld medical device FDA cleared for the treatment of anxiety and insomnia and the relief of pain. Alpha-Stim has been shown in over 100 research studies and more than 40 years of clinical experience to be effective and safe. Alpha-Stim is designed to be used by the patient at home but does require an order by a licensed healthcare provider in the United States.
The sensation of pain transmits through your body along billions of nerve cells designed to transmit pain messages through electrochemical signals. Alpha-Stim utilizes microcurrent electrical therapy (MET) to modulate the signals within nerve pathways to provide significant pain relief and pain management without medication. Instructions for how to complete a pain treatment protocol can be found at https://alpha-stim.com/how-to-use-m/. Pain relief, even from chronic pain, can generally be obtained in one session. Additionally, the results are cumulative, so the more frequently Alpha-Stim is used, the better the pain relief is and the longer it lasts. 
In order to treat the anxiety and insomnia that is comorbid with pain, Alpha-Stim utilizes cranial electrotherapy stimulation (CES) via earclips attached to the earlobes. The result is a comprehensive approach that relieves pain as well as treating the comorbid anxiety and insomnia safely and effectively. See https://alpha-stim.com/risk/ for information on mild and self-limiting side effects.
Scientific Evidence for Alpha-Stim®
As mentioned above, there are over 100 clinical studies that consistently demonstrate Alpha-Stim’s effectiveness and safety in relieving pain and treating anxiety and insomnia. Alpha-Stim reduced pain as much as 85% in as little as eight days in patients with chronic, refractory pain.1 Veterans not only experienced significant pain relief with Alpha-Stim, but also had improvements in the level to which pain interfered with daily functioning and the level of distress veterans experienced due to the pain, and comorbid anxiety.2 Alpha-Stim was also beneficial in relieving pain as well as treating anxiety and insomnia by more than 50% in approximately half of patients with advanced stages of cancer.3 Finally, in patients diagnosed with fibromyalgia, Alpha-Stim significantly reduced pain and insomnia, while improving feelings of well-being and quality of life.4 These studies consistently demonstrate Alpha-Stim’s success in not only quickly and safely relieving pain, but also treating anxiety and insomnia.
Alpha-Stim Benefits Witnessed by this Author
As impressive as the scientific evidence for Alpha-Stim’s safety and effectiveness is, the clinical results are even more so. I have treated hundreds of individuals suffering with chronic pain using Alpha-Stim, both when I was clinical psychologist with the Veterans Health Administration and in my current role as Clinical Education Director for Electromedical Products International, Inc. The results I have witnessed are nothing short of incredible.
Case Study #1: My first experience in seeing the relief from chronic pain was from a veteran in his mid-40s with a history of five back surgeries. He came to the outpatient clinic where I worked as a psychologist on a “bad pain day.” He was having difficulty walking, was unable to stand up straight, and moved very gingerly. 
After he used Alpha-Stim, he was able to stand up from his chair and announced his back no longer hurt. In addition, he reported feeling very relaxed and calm, rather than anxious and “keyed up.” A week later, when he returned to the clinic, he reported his pain relief had lasted for approximately six hours, and returned when he was riding a horse that afternoon.
Case Study #2: I also treated a Vietnam veteran in his 70s, who walked to his car after his treatment, only to turn around and walk back to my office, a total distance of approximately a quarter mile, to report he was pain free for the first time in decades. With consistent treatments, this veteran reported a decrease in anxiety and improvement in both quality and quantity of sleep. Another Vietnam Veteran, during his initial Alpha-Stim treatment while participating in a therapy group, began raising his arm and lowering it repeatedly. When I asked what he was doing, he held his arm up so his elbow was slightly lower than his shoulder, announced he had not been able to move his arm more than that in over a decade, then raised his arm over his head so his arm was straight up. I worked with many veterans who, after using Alpha-Stim consistently to relieve their pain and treat their anxiety and insomnia, were able to work with the physicians and reduce or discontinue their pain, mood, and sleep medications.
Case Study #3: In North Carolina, I treated a man with bilateral knee pain who had slightly impaired mobility as a result. He was able to walk independently, but his gait was shortened, and his pace was slowed. Following a single treatment with the Smart Probes and ear clips, he reported no pain in his knees and, to prove the point, quickly jogged up and down a set of stairs. The next day, he reported sleeping better than he had in months, despite the fact he was sleeping in a hotel room, a situation that is not historically conducive to quality sleep for him. Recently, in Tennessee, a colleague treated a woman with chronic and severe pain in her neck and shoulders. At the time of the treatment, her pain was more severe on the right side of her neck, so he focused slightly more on the right side than the left. The next morning, she returned to us, stating the right side of her neck was still pain free, and she had slept very well, but the left side of her neck was now so painful she was unable to turn her head. My colleague treated her neck and shoulders again, at which point her pain was completely relieved and she had full mobility in her neck.
Patients who suffer with chronic pain are acutely aware that the pain is only part of their distress. The neurological and emotional difficulties that co-occur with their pain can be just as inhibiting in their daily lives. Yet, despite this well-established connection between chronic pain and chronic stress, that can increase risk factors for anxiety and insomnia, most treatment approaches focus solely on the pain. This incomplete treatment approach is often only partially successful in helping improve feelings of well-being and quality of life. Patients seeking a more comprehensive treatment approach for their chronic pain should consider asking their healthcare providers about Alpha-Stim.
References
- Kulkarni, A.D. (2001). The use of microcurrent electrical therapy and cranial electrotherapy stimulation in pain control. Clinical Practice of Alternative Medicine, 22:99-102.
- Morrow, D.J., Fischer, E.P., Walder, A.M., & Jubran, N.I. (2019). Nonopioid alternatives to addressing pain intensity: A retrospective look at two noninvasive pain treatment devices. Federal Practitioner, 364, 181-187.
- Yennurajalingam, S., Kang, D-H., Hwu, W-J., Padhye, N.S., Masino, C., Dibaj, S.S., Liu, D.D., Williams, J.L., Lu, Z., & Bruera, E. (2018). Cranial electrotherapy stimulation for the management of depression, anxiety, sleep disturbance, and pain in patients with advanced cancer: A preliminary study. Journal of Pain and Symptom Management, 552, 198–206.
- Lichtbroun, A.S., Raicer, M.C., & Smith, RB. (2001). The treatment of fibromyalgia with cranial electrotherapy stimulation. Journal of Clinical Rheumatology, 72, 72-78.
ABOUT THE AUTHOR
Officer (RET) Tom McMurtry, Sinclair Police Department, has served as a patrol officer for almost 15 years. He came to police work late in life, attending the police academy at the age of 49. He has served as a Field Training Officer, Evidence Technician, Crisis Intervention Officer, and bicycle mechanic. He received the Distinguished Action Award for his response to the mass shooting in the Oregon District of Dayton, Ohio on August 4, 2019. Officer McMurtry retired from the Sinclair PD in July of 2020.
Captain (RET) Tom McMurtry, U.S. Army Special Forces served on active duty and as a reservist for more than 30 years. He was a paratrooper for 24 years and participated in the invasion of Iraq in 2003. He is the recipient of several awards including the Bronze Star, Meritorious Service Metal, Army Commendation Metals, Army Achievement Metals, Master Parachutist Badge, HALO Parachutist Badge and the Special Force Tab.
Contentment Magazine
The dictionary defines “content” as being in a state of peaceful happiness. The AIS magazine is called Contentment because we want all of our guests and members to find contentment in their lives by learning about stress management and finding what works best for each them. Stress is unavoidable, and comes in many shapes and sizes that makes being in a state of peaceful happiness seem like a very lofty goal. But happiness is easy to find once you are able to find ways to manage your stress and keep a healthy perspective when going though difficult times in life. You will always have stress, but stress does not always have you!