Electrotherapy for Pain Management

Electrotherapy devices deliver low level electrical impulses via electrodes placed on the skin. The mechanism for pain relief is defined in two major theories: gate control(1) and opiate-mediated control(2).

The gate control theory is based on stimulating A-beta fibers to inhibit nociceptive nerve fibers (A-delta, C fibers) from transmitting painful stimuli to the spinal cord.

The opiate-mediated control theory is based on stimulation of the sensory nerves at 10 Hz or less which causes the body to produce endorphins and enkephalins that bind to specific receptor sites in the central and peripheral nervous system blocking the perception of pain.

Electrotherapy Benefits
Electrotherapy is a convenient and easy way for patients to take control of their pain:

• Decreases pain, improves function, and increases activity
  
• Deliver as needed: home, work or on-the-go
• Non-pharmacological option without side effects may allow for patient's return to work and daily activities sooner
• Cost effective, safe and easy to administer
• No risk of drug-to-drug interaction

Research Supports Efficacy
Efficacy of Electrical Nerve Stimulation for Chronic Musculoskeletal Pain: A Meta-Analysis of Randomized Controlled Trials
Johnson M, Martinson M. Pain 130 (2007) 157-165

The overall results showed a significant decrease in pain with ENS therapy using a random-effects model. These results indicate that ENS is an effective treatment modality for chronic musculoskeletal pain and that previous, equivocal results may have been due to underpowered studies (see abstract on back)

Transcutaneous Electrical Nerve Stimulation for Low Back Pain
A comparison of TENS and Massage for Pain and Range of Motion
Melzack R, Vetere P, Finch L. Physical Therapy, Vol 63 Number 4, 493 April 1983

The results show clearly that TENS is an effective modality for the treatment of low back pain. Because of the double blind, randomized design of the study, the significant effectiveness of TENS cannot be attributed to other factors such as placebo efficiency or other psychological effects.

References: (1) Melzack R, Wall PD. Pain mechanisms: a new theory. Science. 1965;150:1971-979. (2) Bengt H. Sjolund and Margareta B. E. Eriksson. Endorphins and analgesia produced by peripheral conditioning stimulation. Advances in Pain Research and Therapy, Vol. 3 edited by John J. Bonica et al. Raven Press, New York © 1979