551 Patient Study - Idiopathic

Renee S. Hartz MD, David B. Phillips Ph.D., Rita Wickham Ph.D., RN., Jill Howe DC, Dynamic Health and Wellness Center, Crystal Lake, Il, USA


Renee S. Hartz, MD Dynamic Health and Wellness, Crystal Lake, Il
1032 Baldwin Lane
Oak Park, Il 60302
facsimile 708-386-5547

David B. Phillips, Ph.D.
ReBuilder Medical, Inc.

Rita Wickham Ph.D. Northern Michigan University

Jill Howe, DC, Dynamic Health and Wellness Center, Crystal Lake, Il


We treated 551 patients for their nerve pain (Peripheral Neuropathy) using ReBuilder®, a unique TENS/EMS electrical stimulation device – used to determine if it improved the quality of the patients’ life. Fully 94% reported success. The patients reported no side effects. The ReBuilder® is safe and effective for treating peripheral neuropathy.


  • Treating patients feet using the split compartment electrode-containing solution.
  • Silver laced conductive gloves (not used in this trial). Socks also available.
  • Close up of the ReBuilder®. Note the small size and portable nature.
  • Mean pain ratings before and after using the ReBuilder®.

    551 Patient Study

    Renee S. Hartz MD, David B. Phillips Ph.D., Rita Wickham Ph.D., RN., Jill Howe DC, Dynamic Health and Wellness Center, Crystal Lake, Il, USA Renee S. Hartz, MD Dynamic Health and Wellness, Crystal Lake, Il 1032 Baldwin Lane Oak Park, Il 60302 facsimile 708-386-5547 David B. Phillips, Ph.D. ReBuilder Medical, Inc. Rita Wickham Ph.D. Northern Michigan University Jill Howe, DC, Dynamic Health and Wellness Center, Crystal Lake, Il Abstract: We treated 551 patients for their nerve pain (Peripheral Neuropathy) using ReBuilder®, a unique TENS/EMS electrical stimulation device – used to determine if it improved the quality of the patients’ life. Fully 94% reported success. The patients reported no side effects. The ReBuilder® is safe and effective for treating peripheral neuropathy. Figures: Treating patients feet using the split compartment electrode-containing solution. Silver laced conductive gloves (not used in this trial). Socks also available. Close up of the ReBuilder®. Note the small size and portable nature. Mean pain ratings before and after using the ReBuilder®.


    Peripheral neuropathy (PN) is the most common neuromuscular disorder and usually presents as symmetric distal polyneuropathy. The estimated incidence of peripheral neuropathy in the general population is 2.4% and 8% in persons older than 55 (1). The most frequently reported cause of peripheral neuropathy is diabetes; 40%-50% of patients who have had type 2 diabetes for10 years have peripheral neuropathy and 26% of all diabetic patients have painful peripheral neuropathy (2,3). Another risk group is cancer patients who receive chemotherapy agents that are neurotoxic to the peripheral nervous system. These agents include (platinum analogs, taxanes, vinca alkaloids, thalidomide, bortezomib, and ixabepilone) (4,5). PN also occurs in patients with HIV and may arise in those with amyloidosis, Sjogren’s syndrome, or other conditions. In many cases is idiopathic (6,7,8). Whatever the cause, PN often causes significant morbidity PN can alter mobility and balance, fatigue, depression, anxiety, and decreased quality of life (9).

    Peripheral neuropathy has an insidious onset, starting in the distal ends of the longest neurons and progressing slowly over months to years. Manifestations originate in the toes and fingers. It then gradually progresses to the feet and hands (stocking and glove pattern). It rarely extends to above the knees and the elbows (8). Although PN can affect motor and (rarely) autonomic nerves, large and small afferent sensory neurons are most often affected by PN. Manifestations may include distressing bilateral nerve pain, paresthesia, and impaired temperature, touch, vibratory sense, proprioception, and loss of deep tendon reflexes (DTRs) (10). Some individuals also experience difficult to manage neuropathic pain in the affected areas. This arises as a direct consequence of the pathogenic event affecting the peripheral somatosensory system (11). In addition to paresthesia, individuals may experience other symptoms. These symptoms reflect damage to small A and C nerve fibers. Shooting, electric or shock-like, or stabbing (lancinating or knife-like) pain (9,12). Other persons report allodynia after contact with non-painful stimuli (e.g. clothing or bed sheets against the skin), pain when walking that feels like walking on marbles or on hot sand, or feelings of heat, burning, or cold in their feet.

    Most research has focused on diabetic neuropathy. There are few adequately powered, well-designed studies to firmly establish optimal pharmacologic treatment (Bril, et al, 2011)(13). Research regarding the management of peripheral neuropathy from other causes lags behind.

    There is little data supporting the use of non-pharmacologic measures. However, there is some intriguing data regarding transcutaneous nerve stimulation (TENS) and related technologies. For instance, Jin and colleagues (2010) (17) reviewed the literature to identify studies comparing TENS to sham treatment for symptomatic diabetic peripheral neuropathy. They identified only three small studies that met the inclusion criteria. These studies confirmed that active TENS (alone or with amitriptyline) used for 30 minutes once a day for 4-12 weeks was significantly superior to placebo in reducing pain and subjective symptoms of peripheral neuropathy. Similarly, Pieber and others (2010) (18) reviewed 15 studies of TENS and other forms of external electrotherapy (e.g. pulsed dose electrical stimulation, high-frequency muscle stimulation, frequency-modulated electromagnetic neural stimulation). They concluded these methods are continued benefits for patients with painful diabetic PN. Although four of the studies reviewed suffered from small sample sizes, most lacked a placebo or control group. Follow up was inconsistent across studies. Interestingly, there was some evidence that the electrical stimulation methods might be more effective than TENS. Hypotheses for these therapies is that they may act by supraspinal mechanisms, modulate descending inhibitory pathways, increase pain threshold, influence calcitonin, reduce windup, or reduce nerve impulse transmission from damaged neurons.

    Our clinical observations and reports from patients experiencing painful PN that support the potential value of a new device, ReBuilder®. (22) ReBuilder® is designed to deliver dual electrical stimulation to muscle and nerve tissues (ReBuilder Medical Inc.). We were encouraged to develop a more rigorous rationale for using or recommending this device. After discussions with several of our patients and their physicians, these patients and physicians expressed extreme frustration at the lack of effective therapeutic options. Some patients even expressed suicidal thoughts because of unrelieved peripheral neuropathy and pain. These findings form the basis for this preliminary study. A review and analysis of patient-generated data collected by ReBuilder Medical Inc.


    The ReBuilder® device is registered with and cleared by the FDA as a 510K pre-amendment version TENS (transcutaneous electrical stimulator) and an electronic muscle stimulator (EMS )(24). The ReBuilder® delivers energy via cutaneous electrodes to each foot (and hand, if indicated). Newer versions offer the alternative of silver-impregnated socks and gloves for signal output. (figure 1). According to the manufacturer, the ReBuilder® individualizes its outputs based on the physical mass and digital impedance of the individual using it (https://rebuildermedical.com) which gives an unequaled level of safety.

    The very real medical advance is in the use of an internal microprocessor that analyzes the patient’s current, dysfunctional peripheral nerve waveform, and then designs a compensating waveform (like noise-canceling headphones) that it delivers to all the peripheral nerves from the spinal cord to the feet. Just as a pacemaker must imitate the waveform of a healthy heart or risk retrograde blood flow, it is reasonable that the peripheral nerves function via a very specific waveform. A common TENS device delivers a constant square wave that is foreign to the nerves.

    ReBuilder’s® impulses utilize very small amounts of current under the curve and a relatively high transient voltage of 40-90 volts. The resultant current is below that commonly produced by traditional TENS units. The device delivers a second, simultaneous, lower voltage (5-20 volts), wider waveform signal designed to stimulate muscle tissue. This signal causes the muscles of the feet, calves, and thighs and buttocks to intermittently contract and relax. Stimulating the venous muscle pump to empty veins thus allowing whatever arterial pressure is present to rapidly fill the vacated veins. This enhances local blood flow. Using this dual stimulation (80% nerve stimulation and 20% muscle stimulation) is pulsed at a frequency of 7.83 cycles per second. Theoretically, this allows afferent neurons time to repolarize between pulses. The dual stimulation is hypothesized to travel from the distal end of the ascending sensory neuron, across the spinal interneuron, and down to the distal end of the motor neuron in the contralateral limb.


    551 individuals who purchased the ReBuilder® between December 2002 and May 2004 comprised this convenience sample. These individuals responded to an Internet advertisement offering a financial incentive for trying a new treatment for peripheral neuropathy. The package the 551 respondents received included a ReBuilder® device and a simple survey questionnaire which they filled out and returned within three months. They were also asked to record their reason for using the device (pain or other symptoms) and to rate their pain, if applicable, on a numerical rating scale (NRS) of 1 (least) to 10 (worst) before and after using the device.

    Statistical Analysis

    Statistical tests were performed using the SPSS software version 20 (IBM, Armonk, N.Y.), and included calculation of descriptive statistics, means, and frequencies for putting together categorical variables. Using a paired t-test to examine any differences in beginning and end of trial pain ratings in persons who reported initially reported pain. We performed a one-way analysis of variance (ANOVA), comparing the differences in pain score changes in the 3 groups of respondents; a) those reporting an improvement in pain, b) those who were unsure whether their pain improved, and c) those who stated that their pain had not improved.


    Excluded were twenty records, due to conflicting or confusing data. The remaining 531 records formed the basis of this report. Eighty-eight percent of respondents did not know the cause of their PN. Only 7% reported their neuropathy was due to diabetes, 3% reported it was anatomic, and 1% each reported toxic or vascular causes. We asked for no other demographic data. ANOVA revealed a significantly greater reduction in pain score in ‘yes’ responders, as compared to the ‘equivocal’ and ‘no’ responders (p<0.0001). In addition, 94% of respondents reported improved quality of life after using the ReBuilder®. A greater number of individuals reported on their satisfaction with pain relief (n = 515) than initially reported pain (n = 456). This discrepancy is explained by individuals who initially reported severe nerve pain or tingling in their feet but still reported an improvement in pain score.

    Testimonials from the questionnaires were not analyzed statistically.
    The most common comments were “miraculous relief,” “I can feel my feet again, ” I am no longer suicidal,” and “I have a life again.”
    Unexpected comments included ulcer-healing in 3 patients, resolution of fungal nail infection in one, and improved sexual function in 3 patients.


    One potential advantage of the ReBuilder® over other technologies including ST5 or TENS is its simplicity of use. In particular, the ST5 treatment must be administered in the clinic and ideally administered by a specially trained clinician. The manufacturer of the ST5 now requires that physicians attend a three-day training course. Additionally, the correct placement of electrodes for optimal local pain relief is why this course is required(23). There are two versions of the ReBuilder®, both FDA registered. One device is for home use and one device for clinic setting use.

    There are numerous causes of peripheral neuropathies. Axonal degeneration, occurring secondary to accumulation of toxins or neurotoxic agents could be the cause. Also, vitamin deficiencies inherited genetic abnormalities, hyperglycemia and glucose accumulation within neurons, or other causes(25). The external environment of neurons, such as vascular compromise or ischemia, inflammation, and oxidative stress may cause secondary demyelination and axonal dysfunction(2). Involvement of small and large sensory neurons often leads to manifestations such as nerve pain, tingling, dysesthesia and burning, as well as a change in temperature sensation and proprioception, and loss of DTRs. Resulting neuropathies may lead to severe pain, disability, erectile dysfunction, impaired ability to walk and drive safely, and decreased quality of life(23).

    There is no known cure for peripheral neuropathy and except in the case of diabetes mellitus, where tight glucose control has been reported to effect improvement(26,27). The treatment has been directed largely at relieving symptoms rather than treating the underlying cause. A common TENS is a simple, non-invasive treatment for neuropathic pain based on the gate control theory(28). that proposes stimulation of large myelinated A-fibers inhibits transmission of painful afferent impulses from A ? and C fibers to the dorsal horn of the spinal cord, thereby closing the gate. This hypothesis may be too simplistic, as central mechanisms may be involved. Furthermore, TENS therapy may not change C or A? mediated thresholds or perceptions (e.g. cold, warmth, cold or heat pain, vibration or touch)(29). TENS may be useful for localized neuropathic pain related to diabetes and other conditions and often leads to improvement of pain that diminishes with the cessation of TENS use(17,18,29) was an overall improvement in peripheral neuropathy pain at twelve weeks of treatment. Current evidence-based guidelines conclude TENS is “probably effective in lessening the pain of painful diabetic neuropathy and improving quality of life” (Bril et al)(13). The primary method of action is that of blocking the nerve path (by overstimulating the nerve cell with a foreign waveform simple square wave) delivered at a higher rate than 7.83 Hz (the rate required for a nerve cell to repolarize).

    The ReBuilder® is distinctly different from traditional TENS units. From “scrambling” types of electrical stimulation, its design opens the nerve paths rather than closing them. It also improves the microcirculation, re-polarizes and re-educates the nerves to follow the correct pathways rather than to confuse the nerve fibers. Its simple design allows for home use. Recent versions include silver-imbued gloves and stockings for home use, further simplifying the treatment process and making it portable.


    There is little information about the self-selected sample, particularly in terms of etiology and duration of peripheral neuropathy, and other medical data. Additionally, there is no follow up data regarding continued use and duration of pain relief in the yes responders. Correspondingly, we cannot say whether those whose responses were ‘equivocal’ or ‘no’ would respond with further use of the ReBuilder®; that is, we do not know the time frame in which the onset of and maximal pain relief occur.


    We have found no other published data or information that includes a large number of individuals (more than 500) experiencing painful neuropathy detailed in our report. Despite the limitations identified, we believe this provides compelling information that should drive larger prospective studies. Future studies should answer further questions that remain open: 1) can use of the ReBuilder® return some degree of peripheral normal sensation, 2) is pain reduction lasting or not, 3) can the ReBuilder® delay the onset of peripheral neuropathy in patients with diabetes or those who are prescribed neurotoxic chemotherapy? Other investigators may also be interested in elucidating the mechanisms of pain relief of the ReBuilder®. Our hypothesis is that the electric stimuli promote healing of the microcirculation and re-direct the small neurons into an appropriate arrangement. Finally, nerve conduction velocity (NCV) studies are considered the gold standard of diagnosing peripheral neuropathy, and should be included in future studies pre- and post-treatment to determine whether velocity improves. In this unpublished study, the ReBuilder® is found to be safe and effective in mitigating pain in peripheral neuropathy. Therefore, we highly recommend the ReBuilder® as a first choice for you to consider in the management of pain as a symptom of peripheral neuropathy.


    1. England JD & Asbury AK. Peripheral neuropathy.2004; Lancet 363: 2151-2161.


    2. Little AA, Edwards JL, Feldman EL. Diabetic Neuropathies. 2007; Pract Neurol 7: 82-92.
    3. Boulton AJM. Management of diabetic peripheral neuropathy.2005; Clin Diabetes 23: 9-15.
    4. Malik B & Stillman M. Chemotherapy-induced peripheral neuropathy.2008; Curr Neurol Neurosci Rep8: 56-65.
    5. Wickham R. Chemotherapy-induced peripheral neuropathy: a review and implications for oncology nursing practice. 2007; Clinl J Oncol Nurs 11:361-376.
    6. Chaia J & Logigian EL. Neurological manifestations of primary Sjogren’s syndrome. Curr Opin Neurol. 2010; 23:509-513.
    7. Simpson DM, Schifitto G, Clifford DB, et al. Pregabalin for painful HIV neuropathy. A randomized, double-blind, placebo-controlled trial.2010; Neurology; 74:413-420.
    8. Vavra MW & Rubin DI. The peripheral neuropathy evaluation in an office-based neurology setting. 2011; Semin Neurol 31:102-114.
    9. Tesfaye S. Advances in the management of diabetic peripheral neuropathy.2009; Curr Opin Support Palliat Care 3:136-143.
    10. Kanji JN, Anglin RES, Hunt DL, Panju A. Does this patient with large-fiber peripheral neuropathy?2010; JAMA303:1526-1532.
    11. Treede R-D, Jensen TS, Campbell JN, Cruccu G, Dostrovsky JO, Griffin JW, et al. Neuropathic pain. Redefinition and a grading system for clinical and research purposes.2008; Neurol 70: 1630-1635.
    12. Hovaguimian A & Gibbons CH. Diagnosis and treatment of pain in small-fiber neuropathy. 2011; Curr Pain Headache Rep 15:193-200.
    13. Bril V, England J, Franklin M, et al, Evidence-based guideline: Treatment of painful diabetic neuropathy. 2011;Neurology 76:1758-1765.
    14. Jensen TS, Madsen CS, & Finnerup NB. Pharmacology and treatment of neuropathic pains. 2009; Curr Opin Neurol 22:467-474.
    15. Rahn EJ & Hohmann AG. Cannabinoids as pharmacotherapies for neuropathic pain: from the bench to the bedside. 2009; Neurotherapeutics 6: 713-737.
    16. Wilsey B, Marcotte T, Tsodikov A, Millman J, et al. A randomized placebo-controlled crossover trial of cannabis cigarettes in neuropathic pain.2008; Pain 9:506-521.
    17. Jin D-m, Xu Y, Geng D-F, Tan T-B. Effect of transcutaneous electrical nerve stimulation in symptomatic diabetic peripheral neuropathy: A meta-analysis of randomized controlled trials. 2010; Diabetes Res Clin Pract 89:10-15.
    18. Pieber K, Herceg M, Pernostro-Sluga T. Electrotherapy for the treatment of painful diabetic peripheral neuropathy: a review. 2010; J Rehab Med 42: 289-95.
    19. Ricci M, Pirotti S, Scarpi E, Burgio M, et al. Managing chronic pain: Results from an open-label study using MC5-A Calmare device. 2011; Support Care CancerMar 11, Epub PMID21394458
    20. Sabato AF, Marineo G, & Gatti A. Scrambler Therapy. 2005; Minerva Anesthesiol 71: 479-482.
    21. Smith TJ, Coyne PJ, Parker GL, Dodson P et al. Pilot trial of a patient-specific cutaneous electrostimulation device (MC5-A Calmare ) for chemotherapy-induced peripheral neuropathy. 2010; J Pain Symptom Manage 40:883-891.
    22. Phillips DB. The ReBuilder System effective Treatment for Neuropathy and Chronic Pain. 2007.
    23. Gormsen L, Rosenberg R, Bach FW, & Jensen TS. Depression, anxiety, health-related quality of life and pain in patients with chronic fibromyalgia and neuropathic pain. 2010; Eur J Pain 14: e1-e8.
    24. Marineo G. Inaccuracy in the article “Managing chronic pain: results from an open-label study using MC5-A Calmare device in Support Care Cancer” (letter). 2011. Support Care Cancer 19:1483-1484.
    25. Head A. Peripheral neuropathy: Pathogenic mechanisms and alternative therapies.2006; Alter Med Rev 11:294-329, 2006
    26. Aring AM, Jones DE, & Falco JM. Evaluation and prevention of diabetic neuropathy. Am Fam Physician 71:2123-2128, 2005.
    27. Ismail-Beigi F, Craven T, Banerji MA, Basile J, Calles jet al. Effect of intensive treatment of hyperglycemia on microvascular outcomes in type 2 diabetes: an analysis of the ACCORD randomized trial. 2010; Lancet 376, 419-430.
    28. Chong MS & Bajwa ZH. Diagnosis and treatment of neuropathic pain. 2003; J Pain Symptom Manage 25 (suppl 5S): S4-S11.
    29. Dubinsky RM & Miyasaki J. Assessment: Efficacy of transcutaneous electric nerve stimulation in the treatment of pain in neurologic disorders (an evidence-based review). 2010;Neurol 74:173-176.
Painful Diabetic Peripheral Neuropathy Study

James R. Arnold D.P.M.

There are approximately 16 million diabetics in the United States, and the World Health Organization estimates that there will be 220 million people worldwide with diabetes by 2010. According to reports, early 50% of the people with diabetes have diabetic polyneuropathy. (1) The neuropathy is associated with the pain in approximately 10% of those patients. Although studies show a relationship between hyperglycemia and the development and severity of diabetic neuropathy, even more, researchers are still unraveling the exact pathophysiology of painful diabetic neuropathy. Currently, both pharmacological and nonpharmacological treatment options are available, but unfortunately, to date, there is no fully effective treatment. (2) I tested the effectiveness of the Rebuilder® system, an electronic neuromuscular stimulator, in a small, open-labeled study of 6 patients with painful diabetic neuropathy. I assessed the ease of use, tolerability and the relief of their neuropathic pain symptoms.


I selected six of my patients who complained about their uncontrolled diabetic neuropathy pain. Consequently, all patients agreed to keep track of their results. Concurrent use of pharmacological therapy was not an exclusion factor. Within 30 days of starting the neuromuscular stimulator, patients had no new treatment regimes. Then I created evenly distributed insulin and non-insulin dependent diabetics groups. There length of time with diagnosed diabetes ranged from one year to twenty-two years; however, the painful diabetic neuropathy ranged from 6 months to 8 years. Two patients were currently taking Neurontin and one was on Elavil. Previous treatments varied from acupuncture, electrical stimulation, nerve blocks and topical creams to pharmacological agents. I stopped data recording at 8 weeks.

Pain levels using a 0-10 pain scale, with 0 meaning the patient had no pain and 10 being the highest rating of intolerable pain.

Furthermore, we provided a 15-minute instructional session on using the simulator and a videotape to the patients.



There are however many advantages of using the electronic neuromuscular stimulator over pharmacological agents for the treatment of painful diabetic neuropathy. Pharmacological therapy includes tricyclic antidepressants, narcotic analgesics, anticonvulsants, and antiarrhythmics. Tricyclic antidepressants have been long considered the standard for chronic diabetic nerve pain, and provide significant pain relief to 30% of patients who have neuropathic pain. Unfortunately, most patients experience intolerable adverse effects such as sedation, dry mouth, urinary retention, orthostatic hypotension or cardiac arrhythmias. Narcotic analgesics are, in a word considered controversial for the treatment of neuropathic pain. The high doses need to relieve the neuropathic pain often lead to constipation and addiction. The anticonvulsant, gabapentin, has become a popular treatment; however, its high price often makes it cost prohibitive and its side effects are considerable. Dizziness 24%, somnolence 23%, headache, and diarrhea 11% – reported by patients. Care: Taken with the antiarrhythmics, and serum level monitored. (3)

The electronic neuromuscular stimulator provides an easy to use, low side effect option that has been shown to provide significant pain relief in patients that suffer from painful diabetic neuropathy. The relief of neuropathic pain may allow some patients to sleep better and increase their quality of life. Use of the electronic neuromuscular stimulator does not prohibit concomitant use of a pharmacological agent.

In conclusion, the electronic neuromuscular stimulator was easy to use and shows promise as a well tolerated, effective treatment for painful diabetic neuropathy. A double-blind, randomized trial must be conducted to confirm my observations.

450 Patient Study - Pain Mitigation and Increased Quality of Life

Maria Bloodworth, PharmD candidate

Marlon Honeywell, PharmD
Associate Professor of Pharmacy Practice

Charlie Colquitt, PharmD
Assistant Professor of Pharmacy Practice

Michael Thompson, PharmD, BCNSP
Professor of Pharmacy Practice, Assistant Dean of Clinical Affairs
Florida A&M University
College of Pharmacy
Tallahassee, Florida

Frank Emanuel, Pharm D
Division Director and Assistant
Professor, Florida A&M University
College of Pharmacy
Jacksonville, Florida

US Pharm. 2007;32(12):66-67.

It is estimated that 10 to 20 million Americans suffer from neuropathy. Associated with various etiologies including diabetes, neurotoxic chemotherapy, alcoholism, and nutrient deficiencies, neuropathy is a microvascular syndrome that affects the autonomic, sensory, and motor neurons of the peripheral nervous system. Neuropathy can be misdiagnosed or under-treated and eventually results in neuropathic pain. Neuropathic pain, which results from nerve cell dysfunction, is characterized by diminished sensation, numbness or tingling in the extremities, deep-seated pain, or increased sensitivity to pain. This malfunction can lead to upregulation of sodium and calcium channels, spinal hyperexcitability, descending facilitation, and aberrant sympathetic-somatic nervous-system interactions.

Neuropathic pain can be debilitating, crippling, and even fatal for some patients. Treatments for neuropathic pain commonly include nonpharmacological therapies, medications, and invasive procedures such as spinal-cord stimulation.2 Conventional pain medications may mask the symptoms associated with neuropathy; however, they are sometimes associated with significant side effects and addiction profiles. Many patients have moderate to severe pain and may require chronic use of multiple medications, which may lead to undesirable adverse reactions and, ultimately, poor patient compliance. Pain is one of the primary reasons patients seek medical attention. If it is improperly controlled, quality of life can be affected, resulting in decreased productivity at work, sleep deprivation, or anxiety or depression.

The ReBuilder®

The ReBuilder® is a noninvasive hand-held device approved by the FDA for the treatment of pain. This treatment device was designed based on the premise that oxygen deficiency is responsible for physical atrophy of nerve cells, which leads to the enlargement of the synaptic junction between the axon of one cell and the dendrites of the next. As a result, it is more difficult for normal-intensity electrical impulses to jump across this synaptic gap, ultimately causing neuropathy. The ReBuilder® is designed to circumvent this gap by waking up dormant nerve cells, relaxing shrinking nerve cells, and restoring normal plus/minus polarity along the nerve axons and dendrites.

The ReBuilder® works simultaneously on three separate levels: stimulation of the nerves, stimulation of the muscles, and combined electrostimulation. The first signal is designed to stimulate the nerves by sending an electrical impulse with a very narrow wave-form and a relatively high transient voltage: 40 to 90 volts AC. This signal restores the nerve function and repolarizes synaptic junctions. The second signal stimulates the muscles by a different, wider waveform with a larger subthreshold amount of current under the curve and a much smaller voltage (5 to 20 AC). Simultaneously stimulating the muscles of the feet, calves, thighs, and buttocks, the ReBuilder® evokes complete relaxation between each contraction stimulus. This increases the flow of oxygen-rich blood to the synaptic junctions, affording effective and efficient conduction of nerve signals. Combined electro­ stimulation uses twin electrical signals to stimulate the nerves and muscle cells. The manufacturer states that the twin electrical signals cause the brain to release endorphins, inducing a sense of well-being and reducing anxiety as well as physical and emotional trauma. Reduction of pain will lead to improvement in patient compliance and quality of life. Additionally, the ReBuilder®features a simultaneous weighted DC signal designed to stabilize the trigger threshold that regulates the sensitivity of the nerve cell. By sending this constant DC signal, the resting potential is held at a fixed voltage long enough for the cell to stabilize itself and regain control.

The ReBuilder® is a patient-friendly device that can be used to treat neuropathic pain. It requires a 30-minute treatment window in which the patient applies conductive gel to each of the signal pads. The pads are then placed on the soles of the feet, the palms of the hands, the lower back, or the shoulders, as needed. Pain relief may last for four to six hours after treatment.

Two models are available: the 300 (personal) and the 2407 (clinical). Both contain the electric stimulator; two lead sets and adhesive signal pads. The manufacturer states that the optional footbath improves patient compliance because it delivers the signal across the entire surface of the foot for comfort, causing vaso­dilation within capillaries and increased infusion of freshly oxygenated blood.4 Other application methods are available, such as heated massage boots and conductive socks and gloves. The heated boot vibrates and enables foot elevation.

The 300 personal model is used for moderate neuropathy and has one output. The 2407 clinical model is used for advanced neuropathy and has two separate outputs, affording the patient the opportunity to concurrently treat two areas: the lower back and the feet, especially neuropathy that involves severe numbness. The 2407 model may be beneficial for visually impaired or arthritic patients because of its large adjustment knobs and the large printing on the case.


ReBuilder Medical, Inc. conducted an internal feedback study evaluating 450 cases. This study observed several different factors to determine the success rate in patients, including average pain level, highest level of pain, and improvement in quality of life. Initially and at the end of 10 treatment sessions, the average pain level was calculated. Observations indicate an average reduction in pain by 27.35% and an increase in quality of life by 81.14%. A decrease in symptoms was reported by 95.76% of patients, and 74.56% of patients felt immediate relief after the first session. Currently, several studies of the ReBuilder® are ongoing.


Although several pharmacologic modalities may be employed to address neuropathic pain, pain control may not be achieved in all patients. The ReBuilder® shows promise for pain mitigation and increased overall quality of life.


  1. The Neuropathy Association. Peripheral neuropathy: facts. Accessed June 18, 2007.


  2. Gilron I, Watson CP, Cahill CM, et al. Neuropathic pain: a practical guide for the clinician. Canadian Med Assoc J. 2006;176:265-275.
  3. McCarberg BH, Billington R. Consequences of neuropathic pain: quality-of-life issues and associated cost. Am J Manage Care. 2006;12(suppl 9):S263-268.
  4. SeekWellness. What is the ReBuilder? Accessed June 22, 2004.
Chemotherapy - Induced Peripheral Neuropathy

October 25, 2010

Dr. David Phillips
CEO and Founder
ReBuilder Medical

RE: ReBuilder® System

On behalf of the Oncology Rehabilitation team and the Medical Staff at Midwestern Regional Medical Center, I want to personally thank you for inventing and developing the ReBuilder® system, a fabulous medical device to help alleviate the symptoms of peripheral neuropathy. In the past, we have used traditional physical therapy electrical stimulation devices such as traditional TENS and Interferential Current (IFC), but the ReBuilder® system provided our patients with Chemotherapy-Induced Peripheral Neuropathy (CIPN) the best and longest lasting pain relief while undergoing chemotherapy treatment.

From 2005 to 2007 we treated 124 cancer patients with CIPN who were actively undergoing chemotherapy treatment at Midwestern Regional Medical Center of which 40% reported a 30% to 50% reduction in their pain scale, 53% reporting 10% to 20% reduction in their pain scale, and 3% reporting 50% or more reduction in their pain scale, and only 4% reported no change.

With these remarkable results (96% success rate) the ReBuilder System is now being used across all four CTCA sites in Tulsa, Phoenix, Philadelphia, and Chicago – touching and helping more oncology patients relieve their CIPN symptoms. This calendar year alone, between all four sites, we have treated over 300 patients successfully.

We believe in your product’s ability to alleviate CIPN symptoms for cancer patients receiving chemotherapy. Patients have reduced or stopped taking pain medicine such as Gabapentin and Lyrica for CIPN.


“It is only… and always will be…..about the patient.” Richard Stephenson, Chairman of the Board at Cancer Treatment Centers of America

Subjective Patient’s Response

Neuropathy & Clinical Research

Chemotherapy is often used to treat different types of cancer. Unfortunately, the use of chemicals to breakdown certain parts of the body to kill cells will ultimately affect all fast dividing cells in the body. As a result several side-effects can and often do occur:

  • Pain
  • Nausea and vomiting
  • Diarrhea or constipation
  • Anemia
  • Malnutrition
  • Hair loss
  • Memory loss
  • Depression of the immune system, hence (potentially lethal) infections and sepsis
  • Weight loss or gain
  • Hemorrhage
  • Secondary neoplasms
  • Cardiotoxicity
  • Hepatotoxicity
  • Nephrotoxicity
  • Ototoxicity

There are currently about 15 widely used treatments for neuropathy. However, more than half of these are treatments that involve some form of medicine to be relied upon. Thus, this results in more side-effects, the very things that caused the problem in the first place.

In some cases, hospitals are at risks when symptoms like neuropathy occur. In cases where there is a misuse, misdiagnosis, or an overdose, the hospital may find themselves in the middle of a lawsuit by the person who received the treatment. The patient has the right to seek council if a misuse of treatment has cause neuropathy or other related lasting effects.

Most of the common reported symptoms are:

  • Numbness
  • Tingling
  • Pain
  • Hypersensitivity
  • Stiffness

On average most patients are seen 1-2 x prior to going home with a home unit.

They continue to self treat at home. Instructions are given to use it daily up to 3x/day.

No actual data at this time for follow up. This will be the next step.

Cancer Treatment Centers of America Patients Stop or Reduce Pain Medications

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