Remote Analgesic Effects Of Conventional Transcutaneous Electrical Nerve Stimulation: A Scientific And Clinical Review With A Focus On Chronic Pain
| Autor: | Shai N. Gozani |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Dorsum
medicine.medical_specialty Analgesic TENS Sensory system Stimulation Review Transcutaneous electrical nerve stimulation law.invention 03 medical and health sciences 0302 clinical medicine Physical medicine and rehabilitation transcutaneous electrical nerve stimulation 030202 anesthesiology law medicine widespread business.industry Chronic pain electrode medicine.disease remote Neuromodulation (medicine) Anesthesiology and Pain Medicine Narrative review business chronic pain 030217 neurology & neurosurgery |
| Zdroj: | Journal of Pain Research |
| ISSN: | 1178-7090 |
| Popis: | Background Transcutaneous electrical nerve stimulation (TENS) is a safe, noninvasive treatment for chronic pain that can be self-administered. Conventional TENS involves stimulation of peripheral sensory nerves at a strong, non-painful level. Following the original gate-control theory of pain, stimulation is typically near the target pain. As another option, remote stimulation may also be effective and offers potential advantages. Objective This narrative review examines mechanisms underlying the remote analgesic effects of conventional TENS and appraises the clinical evidence. Methods A literature search for English-language articles was performed on PubMed. Keywords included terms related to the location of TENS . Citations from primary references and textbooks were examined for additional articles. Results Over 30 studies reported remote analgesic effects of conventional TENS. The evidence included studies using animal models of pain, experimental pain in humans, and clinical studies in subjects with chronic pain. Three types of remote analgesia were identified: at the contralateral homologous site, at sites distant from stimulation but innervated by overlapping spinal segments, and at unrelated extrasegmental sites. Conclusion There is scientific and clinical evidence that conventional TENS has remote analgesic effects. This may occur through modulation of pain processing at the level of the dorsal horn, in brainstem centers mediating descending inhibition, and within the pain matrix. A broadening of perspectives on how conventional TENS produces analgesia may encourage researchers, clinicians, and medical-device manufacturers to develop novel ways of using this safe, cost-effective neuromodulation technique for chronic pain. |
| Databáze: | OpenAIRE |
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