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Assessing and managing pain
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
Lindsey Pollard, Harriet Barker
TENS (transcutaneous electrical nerve stimulations) is a form of electrotherapy that is used in both acute and chronic pain management. A small battery-powered device delivers an electric current via adhesively attached electrodes, with the aim of blocking the pain messages to the brain and, in low-frequency TENS, of producing the body’s natural painkillers: endorphins. The latter can produce analgesia for 5 min to 18 h post-stimulation. Breaks between treatments are advised to reduce habituation in long-term use (Wright 2012). TENS is not recommended as a sole treatment but should rather be used in combination with other pharmacological and non-pharmacological strategies (Table 9.3).
Nonpharmacological Therapies
Published in Pamela E. Macintyre, Stephan A. Schug, Acute Pain Management, 2021
Pamela E. Macintyre, Stephan A. Schug
TENS can be effective in a variety of acute pain conditions (Johnson et al, 2015). It may reduce postoperative pain with or without a decrease in opioid consumption (Li & Song, 2017; Schug et al, 2020) and may also provide short-term relief for acute back pain in emergency care settings; results for longer-term relief are inconclusive (Binny et al, 2019).
Pain relief in labour
Published in Michael S. Marsch, Janet M. Rennie, Phillipa A. Groves, Clinical Protocols in Labour, 2020
Michael S. Marsch, Janet M. Rennie, Phillipa A. Groves
Transcutaneous electrical nerve stimulation (TENS) is a method of pain relief that is self-administered. It is freely available for women to buy. Many hospitals organize rental schemes. the woman may bring the apparatus with her when she is in labour. the woman will normally have already been instructed in its use. in this situation, the use of the device is the mother’s responsibility, but the midwife should give her any necessary assistance. Previous instruction in the use of TENS is usual and desirable.
A systematic review of using electrical stimulation to improve clinical outcomes after hip fractures
Published in Physiotherapy Theory and Practice, 2022
Paul Davison, Rianne Wilkinson, Jordan Miller, Mohammad Auais
Although more studies are needed, regular application of TENS, an inexpensive and effective treatment, seems to reduce pain and permit patients to participate in rehabilitation post hip fractures (Gorodetskyi et al., 2007; Li and Song, 2017). It has also been shown by Gorodetskyi et al. (2007) that patients treated with TENS may rely less on pain medication and require less time in the hospital. However, the evidence remains particularly sparse, and future RCTs with larger samples and longer follow-up periods must be conducted prior to including TENS in routine practice. Future research should sample a population with more compromised health status (e.g. people with dementia), of greater diversity (i.e. race, ethnicity), and older age to better reflect the population of people undergoing hip fracture surgery. Future research should also focus on the effectiveness of TENS in improving adherence to rehabilitation and clinical outcomes in the long-term, and whether this intervention positively influences healthcare utilization patterns (e.g. length of stay, readmissions, medication use). TENS has the potential to save the healthcare system significant expenses if improved functional outcomes, participation in rehabilitation, and reduced pain and length of stay. Further studies should conduct a cost-benefit analysis to assign a monetary value to the effect of TENS and compare it to other measures in reducing pain (e.g. medications).
Effect of electromyographic activity using capacitive and resistive electric transfer on non-specific chronic low back pain: a double-blind randomized clinical trial
Published in Electromagnetic Biology and Medicine, 2022
Michio Wachi, Takumi Jiroumaru, Ayako Satonaka, Masae Ikeya, Yasumasa Oka, Takamitsu Fujikawa
Non-pharmacological therapy, therapeutic exercise, manual therapy, passive modality therapy (ultrasound, TENS, and capacitive and resistive electric transfer [CRET]), and orthotic therapy are administered for NSCLBP treatment. In passive modality therapy, the effects have been reported to reduce pain and improve functional disability (Ansari et al. 2006; Ebadi et al. 2018; Tashiro et al. 2020). Although ultrasound not only reduces pain, but also improves lumbar range of motion, endurance during the Biering-Sorensen test, and functional disability, there were no significant effects on muscle fatigue and H-reflex (Ansari et al. 2006; Ebadi et al. 2012). Similarly, TENS reduces pain through the interception of painful sensations by stimulating the peripheral sensory nerves with a lower threshold (Binny et al. 2019; Johnson et al. 2015). Using CRET for NSCLBP also relieves pain and deep vasodilation, increases the temperature in deep tissue, and improves hemoglobin saturation and ROM (Takahashi et al. 1999; Tashiro et al. 2017, 2020; Yokota et al. 2018). Each modality of therapy focuses on each tissue (surface/deep, nerves, muscles, or blood vessels), and results in different treatment effects. Previous studies did not examine the effect of CRET on functional effects such as muscle activity in NSCLBP.
Combination of pregabalin and transcutaneous electrical nerve stimulation for neuropathic pain in a stroke patient after contralateral C7 nerve transfer: a case report
Published in International Journal of Neuroscience, 2021
Peng Xia, Ting Yang, Xiaoju Wang, Xueping Li
In addition to pharmacologic treatment, physiotherapy is a nonpharmacologic intervention for the management of neuropathic pain. TENS is commonly used as a physiotherapy for long-term neuropathic pain treatment [9]. The aim of TENS is to provide analgesia, improve the vascularization of the stimulated region, and promote muscle relaxation [16]. The previous study showed that the pain was alleviated by TENS in several pathologies by releasing opioids without causing adverse effects [17]. Another study also demonstrated that low-frequency TENS may effectively complement pharmacological treatment in spinal cord injury patients with neuropathic pain [18]. In a blinded, randomized study, the patients with postherpetic neuralgia(PHN) were treated with both pregabalin and TENS therapy or pregabalin and placebo therapy for four weeks each. Patients treated with pregabalin at both high and low doses (600 and 300 mg, respectively) in conjunction with TENS therapy had more pain relief compared to pregabalin at high and low doses used with a placebo device [19].