The Study of Pain Types, its Inhibitory Methods and TENS Effect on Pain

Subject Areas : Renewable energy

Fateme Shyasi ¹ , Mohammad Reza Yousefi ²

1 - Department of Electrical Engineering- Najafabad Branch- Islamic Azad University- Najafabad, Iran
2 - Smart Microgrid Research Center- Najafabad Branch, Islamic Azad University, Najafabad, Iran

Received: 2020-07-12 Accepted : 2020-11-02 Published : 2021-05-22

Keywords: Transcutaneous Electrical Nerve Stimulation (TENS), Pain Relieve, Acute and Chronic Pain, Pain Control,

Abstract :

Pain is an important physiological phenomenon that occurs from birth to the last stages of life. Pain is one of the causes of the patient's referral to clinics and treatment centers. Pain control is one of the major challenges for surgeons and anesthesiologists. Lack of proper pain control lead to hospital­ization and imposes higher treatment costs for patients and hospitals. It causes dissatisfaction with the medical treatment and frequent visits to medicians to control the pain. Medication is not only way for pain reduction; depending on the cause and type of pain, other ways can employ. Electrical stimulation of nerve pain inhibitors through the skin (TENS) is a noninvasive technique to relieve pain. During TENS, pulsed electrical currents are administered across the intact surface of the skin to generate strong nonpainful TENS sensations or mild muscle twitching at the site of pain. This technique inhibits onward transmission of nociceptive (pain-related) information in the central nervous system and appears to be beneficial for acute and chronic pain. In the present study, the effect of TENS on different types of pain investigated and positive outcomes in muscu­los­keletal relief and post-operative pain suggested, although many systematic reviews were inconclusive. 

References:

[1] International Association for the Study of Pain 2010 Annual Report, IASP, 2010.

[2] M. Johnson, “Transcutaneous electrical nerve stimulation: Mechanisms, clinical application and evidence”, Reviews in Pain, vol. 1, no. 1, pp. 7–11, Aug. 2007 (doi: 10.1177/204946370700100103).

[3] K. Sunil Kumar Reddy , M.U.R. Naidu, P. Usha Rani, T. Ramesh Kumar Rao, “Human experimental pain models: A review of standardized methods in drug development”, Journal of Research Medical Sciences, vol. 17, no. 6, pp. 587–595, June 2012 (www.ncbi.nlm.nih.gov/pmc/articles/PMC3634303/).

[4] R. Memar, M. Farokhpur, A. Mesripur, “Medical Pharmacology (nursing-midwifery-anesthesiology)”, 3^rd Edition. Andishe Rafie Pub., 2020 (in Persian).

[5] R. Bousso, K. Poles, D. Cruz “Nursing concepts and theories”, vol. 48, no. 1, pp. 141-145, Feb. 2014 (doi: 10.1590/S0080-623420140000100018).

[6] J.L. Hinkle, K.H. Cheever, “Brunner & Suddarth's textbook of medical-surgical nursing”, 14^th Edition, LWW Pub., 2018.

[7] F. Elahi, “Chronic pain: nature-experience-tolerance”, 1^st Ed., T. Teymurzadeh Pub., Iran: Tehran, 2001 (in Pe­r­sian).

[8] Aghili Khorasani MH. Treatments (Moalejat Aghili). Tehran; Research Institute for Islamic and Complem­en­tary Medicine; 2009:579 (in Persian).

[9] R.P. Francis, M.I. Johnson, “The characteristics of acupuncture-like transcutaneous electrical nerve stimulation (acupuncture-like TENS): A literature review”, Acupuncture and Electro-Therapeutics Research, vol. 36, no (3-4), pp. 58-231, Jan. 2011 (doi: 10.3727/036012911803634139).

[10] M. Johnson, “Acupuncture-like transcutaneous electrical nerve stimulation (AL-TENS) in the management of pain”, Physical Therapy Reviews, vol. 3, pp. 73–93, 1998 (doi.org/10.1179/ptr.1998.3.2.73).

[11] L. Brown, M. Holmes, A. Jones, “The application of transcutaneous electrical nerve stimulation to acupuncture points (Acu-TENS) for pain relief: a discussion of efficacy and potential mechanisms”, Physical Therapy Reviews, vol. 14, no. 2, pp 93-103, April. 2009 (doi.org/10.1179/174328809X405964).

[12] A.W. Rutjes, E. Nuesch, R. Sterchi, L. Kalichman, E. Hendriks, M. Osiri, L. Brosseau, S. Reichenbach, P. Jüni, “Transcutaneous electrostimulation for osteoarthritis of the knee”, Cochrane Database of Systematic Reviews, vol. 7, no. 4, Oct. 2009 (doi.10.1002/14651858.CD002823.pub2).

[13] H. Burri, V. Piguet, “UninTENSional pacemaker interactions with transcutaneous electrical nerve stimulation”, Europace, vol. 11, no. 3, pp. 283–284, Mar. 2009 (doi: 10.1093/europace/eup008).

[14] Y. Coldron, E. Crothers, J. Haslam, W. Notcutt, T. Watson, R. Thomas, D. Sidney, “ACPWH guidance on the safe use of transcutaneous electrical nerve stimulation (TENS) for musculosketal pain during pregnancy”, 2007 (www.electrotherapy.org/downloads/Modalities/TENS in pregnancy guidelines.pdf).

[15] K.E. Nnoaham, J. Kumbang, “Transcutaneous electrical nerve stimulation (TENS) for chronic pain”, Cochr­ane Database of Systematic Reviews, vol. 16, no. 3, July 2008 (doi: 10.1002/14651858.­CD003­222­.pu­b2).

[16] J.M. Bjordal, M.I. Johnson, R.A. Lopes-Martins, B. Bogen, R. Chow, A.E. Ljunggren, “Shortterm efficacy of physical interventions in osteoarthritic knee pain. A systematic review and meta-analysis of randomised placebo-controlled trials”, BMC Musculoskeletal Disorders, vol. 8, no. 51, June 2007 (doi: 10.1186/1471-247­4-8-51).

[17] G. Cruccu, T.Z. Aziz, L. Garcia-Larrea, P. Hansson, T.S. Jensen, J-P. Lefaucheur, B.A. Simpson, R.S. Taylor, “EFNS guidelines on neurostimulation therapy for neuropathic pain”, European Journal of Neurology, vol. 14, no. 9, pp. 952-970, Oct. 2007 (doi: 10.1111/j.1468-1331.2007.01916.x).

[18] C.I. Price, A.D. Pandyan, “Electrical stimulation for preventing and treating post-stroke shoulder pain: A systematic cochrane review”, Clinical Rehabilitation, vol. 15, no. 1, pp. 5–19, Feb. 2001 (doi: 10.1191/02­69­21501670667822).

[19] S. Jena, C.M. Witt, B. Brinkhaus, K. Wegscheider, S.N. Willich, “Acupuncture in patients with headache”, Cephalalgia, vol. 28, no. 9, pp. 969–979, Sept. 2008 (doi.org/10.1111/j.1468-2982.2008.01640.x).

[20] A. Khadilkar, D.O. Odebiyi, L. Brosseau, G.A. Wells, “Transcutaneous electrical nerve stimulation (TENS) versus placebo for chronic low-back pain”, Cochrane Database of Systematic Reviews, vol. 4, no. 4, Feb.  2008 (doi: 10.1002/14651858.CD003008.pub3).

[21] S. Poitras, L. Brosseau, “Evidence-informed management of chronic low back pain with transcutaneous electrical nerve stimulation, interferential current, electrical muscle stimulation, ultrasound, and ther­motherapy”, Spine Journal, vol. 8, no. 1, pp. 226-233, Jan.–Feb. 2008 (doi: 10.1016/j.spinee.­2007.10­.0­2­2).

[22] L.A.C. Machado, S.J. Kamper, R.D. Herbert, C.G. Maher, J.H. McAuley, “Analgesic effects of treatments for non-specific low back pain: a meta-analysis of placebo-controlled randomized trials”, Rheumatology (Oxford), vol. 48, no. 5, pp. 520–527, Dec. 2008 (doi: 10.1093/rheumatology/ken470).

[23] M.I. Bennett, N. Hughes, M.I. Johnson, “Methodological quality in randomised controlled trials of tran­scut­ane­ous electric nerve stimulation for pain: low fidelity may explain negative findings”, Pain, vol. 152, no. 6, pp. 1226–1232, June 2011 (doi: 10.1016/j.pain.2010.12.009. Epub 2011 Mar 23).

[24] S. Hasan, “Comparative Study: Analgesic effect of Al-TENS in variation of treatment time on experimentally induced ischaemic pain in healthy young adult”, Indian Journal of Physiotherapy and Occupational Therapy, Vol. 7, No. 2, pp. 255-260, Jan. 2013 (doi:10.5958/J.0973-5674.7.2.051).

[25] H.O. Handwerker, G. Kobal, “Psychophysiology of experimentally induced pain”, Physiological Reviews, Vol. 73, No. 3, pp. 639-671, July 1993 (doi: 10.1152/physrev.1993.73.3.639).

[26] P.A. Moore, G.H. Duncan, D.S. Scott, J.M. Gregg, J.N. Ghia, “The submaximal effort tourniquet test: its use in evaluating experimental and chronic pain”, Pain, Vol. 6, No. 3, pp. 375-382, May 1979 (doi: 10.1016/0304-3959(79)90055-1).

[27] J.T. Farrar, J.P. Young Jr, L. LaMoreaux, J.L. Werth, R.M. Poole, “Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale”, Pain, Vol. 94, No. 2, pp. 149-158, Nov. 2001 (doi: 10.1016/S0304-3959(01)00349-9).

[28] C.C. Chen, M.I. Johnson, “Differential frequency effects of strong nonpainful transcutaneous electrical nerve stimulation on experimentally induced ischemic pain in healthy human participants”, Clinical Journal of Pain, Vol. 27, No. 5, pp. 434-441, Mar. 2011 (doi: 10.1097/AJP.0b013e318208c926).

[29] M. Ebrahimian, M. Razeghi, A. Zamani, Z. Bagheri, K. Rastegar, A. Motealleh, “Does high frequency transcutaneous electrical nerve stimulation (TENS) affect EEG gamma band activity?”, Journal of Biomedical Physics and Engineering, Vol. 8, No. 1, pp. 271-280, Sept. 2018 (doi:1­0­.316­61/jb­pe.v8i­3sep.780).

[30] K.A. Sluka, C.G. Vance, T.L. Lisi, “High-frequency, but not low-frequency, transcutaneous electrical nerve stimulation reduces aspartate and glutamate release in the spinal cord dorsal horn”, Journal of Neuroc­hem­istry, Vol. 95, No. 6, pp. 1794-1801, Dec. 2005 (doi: 10.1111/j.14714159.2005.03511.x).

[31] G. Leonard, P. Goffaux, S. Marchand, “Deciphering the role of endogenous opioids in high-frequency TENS using low and high doses of naloxone”, Pain, Vol. 151, No. 1, pp. 215-219, Oct. 2010 (doi: 10.1016/j. pain.2010.07.012).