Skip to main content
SpringerLink
Log in
Book cover

Central Pain Syndrome pp 475–480Cite as

Noninvasive Peripheral Nerve Stimulation

  • Chapter
  • First Online:

  • 863 Accesses

Abstract

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 [1]. No experience has been published for CP nor for external noninvasive peripheral nerve stimulation (EN-PNS) ([2]; however, see [3], Table).

This is a preview of subscription content, log in via an institution.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Sabato AF, Marineo G, Gatti A. Scrambler therapy. Minerva Anestesiol. 2005;71:479–82.

    CAS  PubMed  Google Scholar 

  2. Johnson S, Goebel A. Long-term treatment of chronic neuropathic pain using external noninvasive external peripheral nerve stimulation in five patients. Neuromodulation. 2016;19:893–6.

    Article  PubMed  Google Scholar 

  3. Li S, Davis M, Frontera JE, Li S. A novel nonpharmacological intervention – breathing-controlled electrical stimulation for neuropathic pain management after spinal cord injury – a preliminary study. J Pain Res. 2016;9:933–40.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Murakami T, Takino R, Ozaki I, Kimura T, Iguchi Y, Hashimoto I. High-frequency transcutaneous electrical nerve stimulation (TENS) differentially modulates sensorimotor cortices: an MEG study. Clin Neurophysiol. 2010;121:939–44.

    Article  PubMed  Google Scholar 

  5. Kocyigit F, Akalin E, Gezer NS, Orbay O, Kocyigit A, Ada E. Functional magnetic resonance imaging of the effects of low-frequency transcutaneous electrical nerve stimulation on central pain modulation: a double-blind, placebo-controlled trial. Clin J Pain. 2012;28:581–8.

    Article  PubMed  Google Scholar 

  6. Cuypers K, Levin O, Thijs H, Swinnen SP, Meesen RL. Long-term TENS treatment improves tactile sensitivity in MS patients. Neurorehabil Neural Repair. 2010;24:420–7.

    Article  PubMed  Google Scholar 

  7. Banerjee T. Transcutaneous nerve stimulation for pain after spinal injury. New Engl J Med. 1974;291:796.

    CAS  PubMed  Google Scholar 

  8. Long DM, Hagfors N. Electrical stimulation in the nervous system: the current status of electrical stimulation of the nervous system for relief of pain. Pain. 1975;1:109–23.

    Article  CAS  PubMed  Google Scholar 

  9. Davis R, Lentini R. Transcutaneous nerve stimulation for treatment of pain in patients with spinal cord injury. Surg Neurol. 1975;4:100–1.

    CAS  PubMed  Google Scholar 

  10. Hachen HJ. Psychological, neurophysiological and therapeutic aspects of chronic pain: preliminary results with transcutaneous electrical stimulation. Paraplegia. 1978;15:353–67.

    Article  CAS  PubMed  Google Scholar 

  11. Heilporn A. Two therapeutic experiments on stubborn pain in spinal cord lesions: coupling melitracen-flupenthixol and the transcutaneous nerve stimulation. Paraplegia. 1978;15:368–72.

    Article  CAS  PubMed  Google Scholar 

  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 

  14. Eriksson MBE, Sjolund BH, Nielzen S. Long term results of peripheral conditioning stimulation as an analgesic measure in chronic pain. Pain. 1979;6:335–47.

    Article  CAS  PubMed  Google Scholar 

  15. Eriksson MBE, Sjolund BH, Sundbarg G. Pain relief from peripheral conditioning stimulation in patients with chronic facial pain. J Neurosurg. 1984;61:149–55.

    Article  CAS  PubMed  Google Scholar 

  16. Sindou M, Keravel Y. Analgesie par la méthode d’electrostimulation transcutanée. Résultats dans les douleurs d’origine neurologique. A propos de 180 cas. Neurochirurgie. 1980;26:153–7.

    CAS  PubMed  Google Scholar 

  17. Bates J, Nathan PW. Transcutaneous electrical nerve stimulation for chronic pain. Anesthesia. 1980;35:817–22.

    Article  CAS  Google Scholar 

  18. Ray DA, Tai YM. Increasing doses of naloxone hydrochloride by infusion to treat pain due to the thalamic syndrome. Br Med J. 1988;296:969–70.

    Article  CAS  Google Scholar 

  19. Portenoy RK, Yang K, Thornton D. Chronic intractable pain: an atypical presentation of multiple sclerosis. J Neurol. 1988;235:226–8.

    Article  CAS  PubMed  Google Scholar 

  20. Leijon G, Boivie J. Central post-stroke pain: the effect of high and low frequency TENS. Pain. 1989;38:187–91.

    Article  CAS  PubMed  Google Scholar 

  21. Tulgar M, McGlone F, Bowsher D, Miles JB. Comparative effectiveness of different stimulation modes in relieving pain. Part II. A double-blind controlled long-term clinical trial. Pain. 1991;47:157–62.

    Article  CAS  PubMed  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 

  25. Norrbrink Budh C, Lundeberg T. Nonpharmacological pain-relieving therapies in individuals with spinal cord injury: a patient perspective. Complement Ther Med. 2004;12:189–97.

    Article  PubMed  Google Scholar 

  26. Nuti C, Peyron R, Garcia-Larrea L, Brunon J, Laurent B, Sindou M, Mertens P. Motor cortex stimulation for refractory neuropathic pain: four year outcome and predictors of efficacy. Pain. 2005;118:43–52.

    Article  PubMed  Google Scholar 

  27. Cardenas DD, Cardenas DD, Jensen MP. Treatments for chronic pain in persons with spinal cord injury: a survey study. J Spinal Cord Med. 2006;29:109–17.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Schyns F, Coutts F. Does TENS have an effect on neuropathic pain? A pilot study in MS. Eur J Pain. 2007;11(S1):S189–90. A428

    Article  Google Scholar 

  29. Norrbrink C. Transcutaneous electrical nerve stimulation for the treatment of spinal cord injury neuropathic pain. J Rehabil Res Dev. 2009;46:85–93.

    Article  PubMed  Google Scholar 

  30. Pickering AE, Thornton SR, Love-Jones SJ, Steeds C, Patel NK. Analgesia in conjunction with normalization of thermal sensation following deep brain stimulation for central post-stroke pain. Pain. 2009;147:299–304.

    Article  PubMed  PubMed Central  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 

  32. Celik EC, Erhan B, Gunduz B, Lakse E. The effect of low-frequency TENS in the treatment of neuropathic pain in patients with spinal cord injury. Spinal Cord. 2013;51:334–7.

    Article  CAS  PubMed  Google Scholar 

  33. Kılınç M, Livanelioğlu A, Yıldırım SA, Tan E. Effects of transcutaneous electrical nerve stimulation in patients with peripheral and central neuropathic pain. J Rehabil Med. 2014;46:454–60.

    Article  PubMed  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.

    Article  PubMed  Google Scholar 

  35. Bi X, Lv H, Chen BL, Li X, Wang XQ. Effects of transcutaneous electrical nerve stimulation on pain in patients with spinal cord injury: a randomized controlled trial. J Phys Ther Sci. 2015;27:23–5.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Jawahar R, Oh U, Yang S, Lapane KL. Alternative approach: a systematic review of non-pharmacological non-spastic and non-trigeminal pain management in multiple sclerosis. Eur J Phys Rehabil Med. 2014;50:567–77.

    CAS  PubMed  Google 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 

  39. Heutink M, Post MW, Wollaars MM, van Asbeck FW. Chronic spinal cord injury pain: pharmacological and non-pharmacological treatments and treatment effectiveness. Disabil Rehabil. 2011;33(5):433–40.

    Article  PubMed  Google Scholar 

  40. Agripino ME, Lima LV, Freitas IF, Souto NB, Carvalho TC, DeSantana JM. Influence of therapeutic approach in the TENS-induced hypoalgesia. Clin J Pain. 2016;32:594–601.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. HEAVEN/GEMINI International Collaborative Group, Turin, Italy

    Sergio Canavero

  2. AOUCittà della Salute e della Scienza di Torino, Department of Neurosciences, Rita Levi Montalcini, Università di Torino, Turin, Italy

    Vincenzo Bonicalzi

Authors
  1. Sergio Canavero
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Vincenzo Bonicalzi
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Canavero, S., Bonicalzi, V. (2018). Noninvasive Peripheral Nerve Stimulation. In: Central Pain Syndrome. Springer, Cham. https://doi.org/10.1007/978-3-319-56765-5_23

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-56765-5_23

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-56764-8

  • Online ISBN: 978-3-319-56765-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation