Noninvasive Peripheral Nerve Stimulation
Transcutaneous electrical nerve stimulation (TENS) is applied at high frequency (80–100 Hz) (also known as conventional TENS) aimed at activation of myelinated cutaneous sensory fibers or low-frequency stimulation (short trains of impulses at 1–4 Hz, known as acupuncture-like TENS) and aimed at activation of small-diameter nonnoxious muscle afferents and Aδ fibers. Stimulation must be directed over the most painful region, with dual-channel stimulators to cover a large body area with pain. A related technique, called Scrambler therapy, delivers self-learning algorithm-generated non-pain information to the painful area via standard silver gel electrodes. Its average charge is similar to TENS, at a frequency of 43–52 Hz. The protocol consists of 5 days of stimulation followed or not by a 2-day break and then another 5 days of stimulation, 45 min daily. It does not produce paresthesias, and analgesia occurs quickly with a sustained relief for days or months . No experience has been published for CP nor for external noninvasive peripheral nerve stimulation (EN-PNS) (; however, see , Table).
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- 12.Sedan R, Lazorthes Y. La neurostimulation èlectrique thèrapeutique. Soc. Neurochir. Langue Franc. XXVIII Congres Annuel, Neurochirurgie; 1978. p. 1–138.Google Scholar
- 13.Long DM, Campbell JN, Gucer G. Transcutaneous electrical stimulation for relief of chronic pain. In: Bonica JJ, Liebeskind JC, Albe-Fessard DG, editors. Advances in pain research and therapy. New York: Raven Press; 1979. p. 593–9.Google Scholar
- 22.Doctor JN. An evaluation of transcutaneous electrical nerve stimulation (TENS) for the treatment of pain related to a spinal cord injury. Thesis, PhD, University of California, San Diego and San Diego State University 1996:310. In: Boldt I, Eriks-Hoogland I, Brinkhof MWG, de Bie R, Joggi D, von Elm E. Non-pharmacological interventions for chronic pain in people with spinal cord injury. Cochrane Database Syst Rev. 2014;(11):Art. No.: CD009177.Google Scholar
- 23.Tasker RR. Central pain states. In: Loeser JD, editor. Bonica’s management of pain. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2001. p. 433–57. (see also previous edn, 1990).Google Scholar
- 24.Kabirov EI, Staroselseva NG. Transcutaneous electrostimulation in the treatment of dysesthetic pain in syringomyelia. In: 10th World congress on pain, book of abstracts. Seattle: IASP Press; 2002. p. A1656–P204.Google Scholar
- 31.Chitsaz A, Janghorbani M, Shaygannejad V, Ashtari F, Heshmatipour M, Freeman J. Sensory complaints of the upper extremities in multiple sclerosis: relative efficacy of nortriptyline and transcutaneous electrical nerve stimulation. Clin J Pain. 2009;25:281–5.Google Scholar
- 34.Özkul Ç, Kılınç M, Yıldırım SA, Topçuoğlu EY, Akyüz M. Effects of visual illusion and transcutaneous electrical nerve stimulation on neuropathic pain in patients with spinal cord injury: a randomised controlled cross-over trial. J Back Musculoskelet Rehabil. 2015;28:709–19.CrossRefPubMedGoogle Scholar
- 37.Tanei T, Kajita Y, Wakabayashi T. [Pharmacological treatment and neuromodulation therapy for central neuropathic pain: current trend and issue of spinal cord stimulation]. No Shinkei Geka. 2015;43:507–15.Google Scholar
- 38.Nash TP, Williams JD, Machin D. TENS: does the type of stimulus really matter? Pain Clinic. 1990;3:161–8.Google Scholar