Neuroreflexotherapy (NRT) is a type of

alternative medicine Alternative medicine refers to practices that aim to achieve the healing effects of conventional medicine, but that typically lack biological plausibility, testability, repeatability, or supporting evidence of effectiveness. Such practices are ...

treatment used for some cases of

low back pain Low back pain or wiktionary:lumbago#Etymology, lumbago is a common musculoskeletal disorders, disorder involving the muscles, nerves, and bones of the back, in between the lower edge of the ribs and the lower fold of the buttocks. Pain can var ...

(LBP). Small pieces of metal are placed just under the surface of the skin in the ear and back, and are intended to interrupt the neural pain processes. Totally, there are three publications devoted to this method in the world medical science ovacs FM, 1993, 1997, 2002 They are published by the same first author and claim almost absolute efficacy of the therapy and lack of effect of other treatments. Also, three reviews repeat the definition of the method and the claimed results.

Efficacy

A 2005 Cochrane review said that while some limited research reported "surprising" results for the efficacy of this therapy in treating nonspecific LBP, a lack of confirming research made it impossible to reach general conclusions about its overall efficacy. A note from the Co‐Editors of the review says that the conclusions would be more sound "if similar evidence was available from RCTs conducted in other countries, with other care providers and different researchers. The very large positive response in the intervention group compared to the placebo group is unusual for trials in chronic back pain. ... Therefore, ... there is no strong evidence that it will work as well outside the specialty clinics in Spain."

Side effects

Negative skin reactions have been described including

dermatitis Dermatitis is a term used for different types of skin inflammation, typically characterized by itchiness, redness and a rash. In cases of short duration, there may be small blisters, while in long-term cases the skin may become thickened ...

and skin infections.

Technique

In the procedure, small pieces of metal are placed in the skin of the back and ear: surgical staples are placed through the outer layer of skin, and burins are implanted just beneath the skin surface. The pieces are either removed or fall out on their own between two weeks and three months after implantation. The procedure is done on an outpatient basis, and takes about one hour to complete. A 2005 review did not find reports of pain or scarring associated with the procedure.

Mechanism of action

The pieces of metal are placed in locations believed to be in neural pain transmission pathways in order to interrupt them. The locations chosen are specific

dermatome Dermatome may refer to: * Dermatome (anatomy), an area of skin that is supplied by a single pair of dorsal roots * Dermatome (embryology), the portion of the embryonic paraxial mesoderm, the somite, which gives rise to dermis * Dermatome (instrument ...

s in the back - regions served by a particular nerve root - along with what Marlowe describes as associated "referred tender points" in the ear. This combination of locations is theorized to reduce pain by interfering with the neural pain transmission and processing pathways, interrupting nerve signals that tighten the lower back muscles, and reducing

neurogenic inflammation Neurogenic inflammation is inflammation arising from the local release by afferent neurons of inflammatory mediators such as substance P, calcitonin gene-related peptide (CGRP), neurokinin A (NKA), and endothelin-3 (ET-3). In such neurons, the r ...

. The metal pieces in the lower back stimulate the release of peptides that inhibit the generation of pain messages, and the ones in the ear are theorized to activate pain-relieving mechanisms in the brain.

History

Several research works in

neurophysiology Neurophysiology is a branch of physiology and neuroscience concerned with the functions of the nervous system and their mechanisms. The term ''neurophysiology'' originates from the Greek word ''νεῦρον'' ("nerve") and ''physiology'' (whic ...

and other fields of medicine were carried out by Prof. Dr. René Kovacs in the second half of the 20th century in France and Spain. These works led to Neuroreflexotherapy (NRT) development which is continued by the Kovacs Foundation since 1986.http://www.aemen.es/nrt_origenydesarrollo.html (Spanish)

References

{{reflist, refs= {{cite journal, last1=Marlowe, first1=Dan, title=Complementary and alternative medicine treatments for low back pain, journal=Primary Care , volume=39 , issue=3 , pages=533–46 , year=2012 , pmid=22958563 , doi=10.1016/j.pop.2012.06.008 {{cite journal , last1=Urrútia , first1=Gerard , last2=Burton , first2=Kim , last3=Morral , first3=Antoni , last4=Bonfill , first4=Xavier , last5=Zanoli , first5=Gustavo , title=Neuroreflexotherapy for Nonspecific Low Back Pain , journal=Spine , volume=30 , issue=6 , pages=E148–53 , year=2005 , pmid=15770167 , doi=10.1097/01.brs.0000155575.85223.14 , s2cid=31140257 {{cite journal, last1=van Tulder, first1=MW, last2=Furlan, first2=AD, last3=Gagnier, first3=JJ, title=Complementary and alternative therapies for low back pain., journal=Best Practice & Research. Clinical Rheumatology, date=August 2005, volume=19, issue=4, pages=639–54, pmid=15949781, doi=10.1016/j.berh.2005.03.006 Pain Medical treatments