Another approach to pain relief is the stimulation of nerve pathways to
reduce pain and facilitation motor function. The simplest form is called
counter-irritation, which is systematic rubbing of the painful part.
Conventional pain therapies that enhance this effect with electrical
stimulation of the nerves include transcutaneous electrical nerve
stimulation (TENS), peripheral nerve stimulation (rarely performed),
spinal cord stimulation (also called dorsal column stimulation), and
brain stimulation. Complementary approaches include acupuncture
(including electrical stimulation of acupoints) and acupressure. The
latter approaches and TENS are most commonly used to treat pain; spinal
cord stimulation is well accepted by pain specialists and its role in
pain management is growing.
Transcutaneous electrical nerve stimulation (TENS)
TENS has been used successfully to help control chronic pain in
various conditions, including chronic neuropathy, arthritis,
postoperative pain, post-fracture recovery, low back pain,
postherpetic neuralgia, myofascial pain, and advanced painful
malignancies (Thorsteinsson, 1987). The device is an electrical unit
that delivers different frequencies and intensities of stimulation to
the skin through electrodes. To increase the chance that TENS can help,
the patient is given a TENS device and then instructed to apply a
variety of different types of stimulation during a trial period.
Patients vary a great deal in the type of TENS that works.
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