For people with diabetes whose feet burn at night
Burning feet that won't let you sleep?Scrambler therapy goes after the pain signal itself — and one $99 session shows you whether your nerves answer.
Scrambler therapy is an FDA-cleared, non-drug treatment for nerve pain — including the burning, tingling and electric shocks of diabetic neuropathy. Small pads go on skin that still feels normally, and the machine sends a calm, non-painful message up the same nerves your pain has been using. No pills. No needles. Nothing implanted. Nothing to recover from. You sit back for about forty minutes, and many people learn early whether their body is answering it.
It starts at the toes. For a while it's just tingling — pins and needles you could ignore.
Then it isn't. Now your feet burn. Some nights it's a bad sunburn. Some nights it's electric — little shocks that fire for no reason and jolt you awake. The soles feel like you're walking on gravel, or on stones, even in soft shoes. And somehow your feet can be numb and on fire at the same time.
Night is the worst of it. The house goes quiet and your feet get loud. You've tried everything with the sheets: feet out from under the covers, a pillow under your calves, a fan at the end of the bed. The weight of a blanket is too much. You know 3 a.m. well.
You've stopped doing things. The long walk. The standing part of a party. The shoes you used to wear. You watch the ground when you walk now.
And you did what you were told. "Keep your sugar under control." You're trying — the diet, the meter, the medicine. Then came the prescription for the feet. Gabapentin, and the fog. Then Lyrica, and the weight. Then duloxetine. Each one turned the volume down a little, or didn't — and the burning is still there at bedtime.
Somewhere along the way you heard some version of this: it's nerve damage from the diabetes — you'll have to learn to live with it.
Here's what that sentence really meant: those are all the tools we have. It was true — about that toolbox. The doctor who said it had almost certainly never seen a scrambler machine. There aren't many, insurance doesn't pay for the treatment, and it sits outside the usual path from one pill to the next. The end of their equipment is not the end of your options. The rest of this page is about the tool they didn't have.
The mechanism
Why your feet burn — and how this goes after it
Start with what's actually happening in your feet.
High blood sugar, over years, wears on the long nerves that run down to your feet. The longest nerves feel it first — that's why it starts in the toes and climbs, and why it's so often worse at night.1
And a hurt nerve does something strange: it keeps firing. It sends "burning" when nothing is burning. It sends "shock" when nothing touched you. Your spinal cord and brain keep listening, and the whole circuit gets better and better at sending a message that isn't warning you about anything real. The pain becomes the habit rather than the alarm.
That's why the pills fall short here. Gabapentin quiets the signal, but it doesn't retrain it — so the dose climbs, and so does the fog. Lyrica and duloxetine work on the volume, too. The message underneath keeps playing.
Scrambler therapy goes after the message.
Small sticky pads — like the ones used for a heart test — go on healthy skin along the nerve pathways that feed your feet.3 Never on the painful spot, and never on numb or broken skin. Where your feet have lost feeling, the pads go higher up, on skin that still feels normally. The whole idea depends on nerves that still carry a signal.
The machine then sends its own signal up those nerves. It isn't a buzz and it isn't random. It's a pattern that keeps changing, shaped to imitate the traffic a healthy nerve sends when nothing is wrong.3 For about forty minutes, your nervous system gets a calm message on the same line that has been carrying the burning.
During a session, many people feel the burning drop right there in the chair. Then the question becomes how long it holds — and that's what the course answers.
Want the full story of the treatment — including how we use it for CRPS, shingles pain and phantom limb pain? It's on our scrambler therapy page.
The questions everyone asks
"Isn't this just a TENS unit?" — and two more
"Isn't this just a TENS unit?"
No. They share a sticky pad and not much else — the New England Journal of Medicine review is clear that scrambler therapy is not a kind of TENS.3 A TENS unit is a gadget you run at home, and its relief is built to last while it's switched on. The scrambler signal comes from the device's own program. It's given as a course, aimed at relief that outlasts the session. And the device is restricted to physicians, or trained staff working under a physician's supervision.2 If a TENS unit did nothing for your feet, that tells you nothing about this.
"My feet are partly numb. Can this still work?"
Numb skin is exactly why placement is done by hand. The pads go where the nerves still carry a signal. Tell us where you feel normally and where you don't — that map is how we set you up, and we work it out fresh every visit.
"Will it hurt?"
No. A properly run session feels like a light, fizzy tingle. If anything makes the pain go up, we stop and move the pads. A session that hurts is a session being done wrong.
If you have diabetes
If you have diabetes, read this part
Your feet need a little more care than most. Here's how we handle it.
Keeping your sugar steady still matters.
It protects your nerves going forward. That job stays with you and your doctor, and nothing here changes it. But steady sugar doesn't switch off burning that's already there. That's the part we go after.
Your diabetes medicine stays as it is.
Metformin and GLP-1 medicines like Ozempic or Mounjaro don't get in the way of scrambler therapy. Keep taking your diabetes medicine exactly as prescribed; managing it stays with you and your doctor. Your nerve-pain medicine is different: gabapentin, Lyrica (pregabalin) and Cymbalta (duloxetine) can interfere with the scrambler signal, so we'll work with the doctor who prescribed them to wean you off gradually. Don't stop them on your own — gabapentin and Lyrica are anticonvulsants, and stopping them all at once can cause seizures. Bring your full medication list.
A sore on your foot comes first.
An open sore, an ulcer, or signs of infection on your feet — redness, heat, swelling, drainage, a fever — go to your medical team first, today. A foot wound in a person with diabetes comes before anything we do. Once it's cared for, we're here.
Numb or fragile skin never gets a pad.
That's a placement rule, and it's how your feet stay safe during treatment.
Unsteady on your feet? Tell us.
You sit for the whole session, and someone is with you the whole time.
What to expect
What a session is actually like
You keep your clothes on — just roll up your pant legs. You sit back in a treatment chair.
The pads go on by hand, patient by patient, on skin that still feels. Then the level comes up slowly, one channel at a time, and here's your only job: tell us what you feel. First tell me when you feel something, then tell me when it's enough.3 The target is a clear tingle that's completely comfortable — people call it fizzing, or tiny electrical ants.3
The session runs about forty minutes.4 People read, scroll, nap, talk.
We don't put the pads on and walk away. Someone is with you the whole time, checking what the burning is doing. If a placement isn't getting the answer we want, we change it in that session — not next week. The goal every session is your pain at zero while you're in the chair.
Then the pads come off and you drive yourself home. No drowsiness, no restrictions. Want to see it first? Watch Dr. Barton walk through a session in the video under Patient stories.
The course
Ten days — and an early answer
A full course is ten sessions, on consecutive weekdays — five days a week for two weeks.4 That's the protocol the device is built around.
It's why we run scrambler sessions on Fridays, when the rest of the clinic is closed — a ten-day course doesn't fit a four-day week. Driving in from out of town? Plan on two weeks in San Antonio.
But you don't decide about ten days on day one. Here's how it actually goes:
- First, a $19 consultation. Your history, your diabetes and your feet, what you've already tried, and the list of reasons someone can't have this treatment (it's further down this page). Plan on about an hour: roughly 30 minutes of consultation and about 30 minutes of treatment.
- Then a $99 first session — credited toward the course. A full session, run properly, so you see what your own nerves do with it. If you continue, the $99 comes off the course.
- Then you decide. If there's a signal, we talk about the full course, and you'll have the number in writing before you commit. If there's no change after a few sessions, we tell you and we stop.
What "working" tends to look like
For people who respond, relief usually builds across the course — each session's relief tends to last a little longer than the last.3 Some people come back later for a short round of booster sessions — usually a couple of days, not another full course. In San Antonio, a booster is a drive, not a flight.
How we measure it
We track how bad the burning is, how often it comes, and what you can do again: sleep through the night, keep the sheets on, stand at the counter, walk to the mailbox. You fill out the same standard questionnaires at the start and at follow-ups, and we watch how you walk and move. We listen to what you tell us — and when something isn't working, you'll know it and so will we.
Weigh it against the alternative
The case for trying this before another prescription
Weigh what it asks of you against what you've been offered. No new pill, and nothing to wean off. No fog. No weight gain. No needles, no implant, no surgery. No downtime — you sit in a chair for about forty minutes and drive yourself home.
Why this works
Why this works — and what we stand behind
Scrambler therapy retrains the pain signal instead of masking it. Here's what makes it work here, and what you can hold us to.
Your first session answers the big question. The fastest way to know whether your nerves respond is to treat them. That's why the first full session is $99 and counts toward the course.
Placement is everything, and it's done by hand. Where the pads go, and a level set by someone listening to your answers — that's the treatment. Dr. Barton trained in the protocol in Rome with the inventor, Giuseppe Marineo, and every course here runs under the medical supervision of Lisa D. Persyn, M.D.
When the burning is stubborn, we bring more. For nerve pain that doesn't answer the scrambler sessions alone, we add parts of the protocol we built for CRPS — gentle desensitizing work while the pain is down, and a setup we keep changing until we get the answer. It's part of your care, with no separate charge.
What we stand behind: a full session before you're asked to invest in a course. The exact number in writing before you commit. Your progress measured and shown to you. And a straight answer at every step.
Candidacy
Who this is for — and who it's not for
Who it's for
People with diabetic peripheral neuropathy whose main problem is pain:
- Burning feet — the sunburn feeling, worst at night
- Pins and needles that don't let up
- Electric shocks and zaps in the toes, feet or legs
- The "walking on gravel" feeling in the soles
- Feet that can't stand the sheets — or socks, or shoes
- Pain that has outlasted gabapentin, Lyrica or duloxetine — or pain you'd rather not keep treating with them
Who cannot have this treatment
These are absolute. They come from the device's own instructions, and no exam changes them:4
- An implanted pacemaker or defibrillator
- A spinal cord stimulator or peripheral nerve stimulator, implanted or in trial
- Aneurysm clips, vena cava clips, or skull plates
- A seizure disorder — epilepsy, or a tendency to seizures
- Pregnancy — the treatment hasn't been studied in pregnancy, so it isn't used
- Undiagnosed pain — if nobody has worked out why your feet burn, that comes first. If that's where you are, we'll help you get to the right person.
Where we take extra care
Heart problems, diagnosed or suspected — we talk to you about it, and there are placements we don't use. Skin that has lost normal sensation, or is broken, infected or fragile where pads would go. A tendency to bleed or bruise easily, or a recent fracture. Some anticonvulsant medicines can change how the course is run — bring your full medication list to the consultation. And occasionally, skin irritation where the pads sit: it's the most common side effect there is, and moving the placement usually solves it.4
Cost & insurance
What it costs — and what you get for it
You've likely already spent a lot on things that didn't touch the burning. So the front end is built around one question: does this work for you?
The consultation is $19.
Your history, an exam, a real conversation about whether this fits your pain, and the candidacy screen above. If the answer is no, you'll hear it at the consultation.
A first full session is $99 — and it counts toward the course.
Not a demo — a full session, run properly, so you find out what your nerves do with this treatment before you're asked to commit. Continue with a course and the $99 comes off it.
The full course is an investment we quote in person.
Scrambler therapy isn't a covered insurance benefit, so the course is an out-of-pocket investment — and you'll know exactly what it is, in writing, before you agree to anything. If your situation is unusual — a workers' comp claim, or a plan that has covered it before — tell us at the consultation and we'll check what's possible.
Your care team
Who does the treatment
With scrambler therapy, who places the pads matters as much as the machine. Results follow placement and the care taken in setting the level. So here's who you'll be working with.
Kevin S. Barton, D.C. has practiced in San Antonio since 2003. He manages the scrambler program, and he does the treatments.
He completed advanced scrambler therapy training in Rome, Italy, with Dr. Giuseppe Marineo — the biophysicist who invented this treatment.5 Training with the person whose research created the device — and he's the one in San Antonio who did it.
The program is medically supervised by Lisa D. Persyn, M.D., who is board certified in Physical Medicine and Rehabilitation — the specialty built around restoring function to people living with pain and nerve injury. That's how this treatment is meant to be delivered: the device is restricted to physicians, or to trained personnel working under a physician's supervision.2 And it means your care is looked at by a physiatrist as well as by the doctor running your sessions.
What that looks like in the room: placement worked out fresh at every visit; the level brought up in steps with you saying where it stops; the setup changed on the spot when the burning isn't answering; and someone with you for the whole session.
Patients
Patient stories
“Highly recommend using Texas Spine Clinic. I've been traveling to Dallas for the last three years and now I can go in San Antonio for scramble therapy.”
Every patient's story is their own. Results vary. These are real Texas Spine Clinic patients, sharing their experiences with their permission.
Questions patients actually ask
Before you call
Can scrambler therapy help diabetic neuropathy in my feet?
It's used for exactly this kind of pain — the burning, the shocks, the pins and needles. The way to find out whether your nerves answer is a $19 consultation and a $99 session. Many people feel a change during that first session.
Will it bring back the feeling in my numb toes?
Scrambler therapy is a treatment for pain. Its target is the burning and the shocks — the nerve shouting — and that's what we measure. At your consultation we'll look at both your pain and your numb areas and tell you plainly what we expect this to reach.
Do I have to stop my diabetes medicine — or my gabapentin?
No, not your diabetes medicine. Metformin and GLP-1 medicines like Ozempic or Mounjaro don't interfere with scrambler therapy, and managing your diabetes medicine stays with you and your doctor. Your nerve-pain medicine is different: keep taking it for now, and don't stop it on your own. Gabapentin, Lyrica (pregabalin) and Cymbalta (duloxetine) can all interfere with the signal scrambler therapy sends, so we'll work with the doctor who prescribed them to wean you off safely. That has to be done gradually: gabapentin and Lyrica are anticonvulsants, and stopping them all at once can cause seizures. Cymbalta can cause withdrawal symptoms if it's stopped suddenly. Bring your full medication list to the consultation.
I have a sore on my foot. Can I still come in?
Call your medical team first. An open wound, an ulcer, or signs of infection on a diabetic foot needs care before anything else — today. Once it's looked after, call us.
How soon will I know if it's working?
Often during the first session. What matters most is whether the relief starts lasting longer between visits — usually clear within the first several days. That's why we'd rather you put $99 into finding out than commit to a full course on hope.
Does it hurt?
No. It's a comfortable tingle — often described as tiny electrical ants. If anything raises your pain, we stop and change the placement.
How many sessions?
A full course is ten, on weekdays over two weeks. Some people come back later for a short round of boosters.
What does it cost — is it covered by insurance?
Scrambler therapy isn't a covered insurance benefit. The consultation is $19, and the first full session is $99, credited toward the course. You'll have the exact investment for a full course in writing before you commit. More on cost.
I have a pacemaker or a spinal cord stimulator. Can I do this?
No. An implanted pacemaker, defibrillator or nerve stimulator rules it out. Knee and hip replacements, screws and rods do not.
Footnotes
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), "Peripheral Neuropathy," Diabetic Neuropathy series — peripheral neuropathy most often affects the feet and legs first, and symptoms are often worse at night. ↩
- Smith TJ, Wang EJ, Loprinzi CL. Cutaneous Electroanalgesia for Relief of Chronic and Neuropathic Pain. New England Journal of Medicine 2023;389:158–64. Review by physicians at Johns Hopkins and the Mayo Clinic. ↩
- Same review — mechanism and application: electrode placement on unaffected skin along the affected dermatomes; the continuously varied waveform sequences; the operator's step-by-step level-setting dialogue; session length; relief typically lengthening over a course; reported durability and retreatment; and the statement that scrambler therapy is distinct from TENS. ↩
- ST-5A device instruction manual (Delta International Services & Logistics, rev. 2020) — indications, warnings, contraindications, precautions and treatment protocol, including session length, the ten-treatment course structure, and the exclusions listed above. ↩
- Dr. Barton completed advanced scrambler therapy training in Rome, Italy, with Dr. Giuseppe Marineo, who developed scrambler therapy at the University of Rome Tor Vergata. ↩
Primary sources on file at the clinic.
The ask
Find out in ten days whether the burning will answer.
Call (210) 741-9166. The consultation is $19 — and it isn't a sales pitch.
- The $19 consultation. Your history, your feet, what you've already tried, and the candidacy checklist. If you're not a candidate, you'll hear it at that visit — along with what we think is worth trying instead.
- A $99 first session — credited toward the course. A full session, done properly, so you see what your body does with this before anyone talks to you about a program.
- You decide, with the number in front of you. If you responded, we'll walk you through the full course and the investment, in writing. If you didn't, we'll say so — and nobody will ask you to try a few more just in case.
Texas Spine Clinic · 3212 Napier Park, San Antonio, TX 78231
Monday–Thursday, 8 a.m.–5 p.m. · Friday: scrambler therapy sessions only, by
appointment.
Book your $19 consultation
No referral needed. Same-day appointments available.
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Rather book by phone? Call (210) 741-9166.
P.S. If your feet have burned for years, you've earned your doubts — and you've probably spent real money on things that didn't help. So here's the one line on this page that matters most: there's a quick, low-cost way to find out whether this works for you. A $19 consultation and a $99 session. Two weeks from now, you could be sleeping with the sheets on. Call (210) 741-9166.