Neuroreflexotherapy

Neuroreflexotherapy (NRT) is an alternative medicine pain management therapy for the treatment of low back pain (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.

Medical uses
A 2005 Cochrane review found that "NRT appears to be a safe and effective intervention for the treatment of chronic non-specific LBP", and that it is more effective than placebo for chronic pain, but its effectiveness for non-chronic low back pain is unclear. These findings were based on a small number of specialized clinics in Spain and so may not be applicable to other areas.

Technique
In the procedure, small pieces of metal are placed in the skin of the back and ear: 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 dermatomes 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. 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
Neurorreflexotherapy was invented in Spain in the late 1970s by René Kovacs, and was then further developed by the Kovacs Foundation. In the 1990s, the Spanish National Health System began offering the treatment to patients.