BlueCross BlueShield of Tennessee Medical Policy Manual

Electrical Stimulation of the Autonomic Sympathetic Nervous System (i.e., Sympathetic Therapy) for the Treatment of Pain


Sympathetic therapy describes a type of non-invasive electrical stimulation of the peripheral nerves with the intent to alleviate chronic pain. Unlike TENS (transcutaneous electrical nerve stimulation) or interferential electrical stimulation, sympathetic therapy is not designed to treat local pain, but is purported to treat chronic pain conditions associated with the sympathetic nervous system.

The autonomic nervous system functions to regulate the body's unconscious actions. It has two divisions: the sympathetic nervous system, which accelerates the heart rate, constricts blood vessels, and raises blood pressure, and the parasympathetic nervous system, which slows the heart rate, increases intestinal and gland activity, and relaxes sphincter muscles.

Based on the location of the patient's pain and treatment protocols supplied by the manufacturer, electrodes are placed in various locations on the lower legs and feet or the hands and arms. Treatment may include daily 1-hour sessions in the physician's office, followed by at-home sessions. Examples of sympathetic therapy delivery systems are the Dynatron® STS™ clinical device and the Dynatron® STS RX™ home unit.




Well-designed studies in peer-reviewed journals are lacking. The safety and efficacy of this technology is unknown.


Guido, E. H. (2002). Effects of sympathetic therapy on chronic pain in peripheral neuropathy subjects. American Journal of Pain Management, 12 (1), 31-34. (Level 4 evidence)

Hurley, D., Minder, P., McDonough, S., Walsh, D., Moore, A., and Baxter, D. (2001, April) Interferential therapy electrode placement technique in acute low back pain: a preliminary investigation. Archives of Physical Medicine and Rehabilitation, 82 (4), 485-93. Abstract retrieved October 5, 2017 from PubMed database.

U. S. Food and Drug Administration. (2001, May). Center for Devices and Radiological Health. 510(k) Premarket Notification Database. K010565 (Dynatron® STS). Retrieved June 2, 2009 from

U. S. Food and Drug Administration. (2001, May). Center for Devices and Radiological Health. 510(k) Premarket Notification Database. K010948 (Dynatron® STS – home model). Retrieved January 5, 2016 from

Washington State Department of Labor and Industries. Office of the Medical Director. (2002, April) Technology assessment: Dynatron® STS. Retrieved October 4, 2017 from 




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