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Nonpharmacological Therapies
Published in Pamela E. Macintyre, Stephan A. Schug, Acute Pain Management, 2021
Pamela E. Macintyre, Stephan A. Schug
Transcutaneous electrical nerve stimulation (TENS) is simple, safe, noninvasive, and free from systemic side effects and allows patients some control over their own therapy. The battery-powered TENS unit generates a small electric current which is transmitted to electrodes placed on the skin. In human experimental pain studies, high-frequency TENS has been shown to have analgesic properties that can be blocked by the administration of naloxone (Leonard et al, 2010).
Pain and Its Management in Older Adults
Published in K. Rao Poduri, Geriatric Rehabilitation, 2017
Annie Philip, Diya Goorah, Rajbala Thakur
Physical therapy will help the patient live more independently by helping them with compensatory techniques for disabilities from their primary disorder, preventing secondary injuries, and treating functional deficits. Strength and endurance training, stretching, isometric strengthening, and aerobic exercises should be incorporated. Myofascial release for treatment of myofascial pain is equally important. Use of modalities such as transcutaneous electrical nerve stimulation (TENS) unit could be beneficial.
Nonpharmacological therapies
Published in Pamela E. Macintyre, Stephan A. Schug, Acute Pain Management, 2014
Pamela E. Macintyre, Stephan A. Schug
Transcutaneous electrical nerve stimulation (TENS) is simple, safe, noninvasive, and free from systemic side effects, and allows patients some control over their own therapy. The battery-powered TENS unit generates a small electric current which is transmitted to electrodes placed on the skin. In human experimental pain studies, high-frequency TENS has been shown to have analgesic properties that can be blocked by the administration of naloxone (Leonard et al., 2010).
Explicit versus implicit lower extremity sensory retraining for post-stroke chronic sensory deficits: a randomized controlled trial
Published in Disability and Rehabilitation, 2023
Hadas Ofek, Mordechai Alperin, Tsipi Knoll, Daphna Livne, Yocheved Laufer
Both sensory interventions focused on the contralesional lower extremity and lower extremity activities. The main difference between interventions was that in the ESR protocol, explicit details were provided regarding sensory stimulation, and participants were requested to actively discriminate between sensory inputs. In contrast, for the IRE approach, the subjects were exposed to sensory enriching and challenging input, but not encouraged to discuss the input or attempt to actively discriminate between different sensations. Both protocols had a common structure involving three 15-min subsections, each addressing a sensory modality group: (1) superficial sensory input (tactile, temperature, and pressure); (2) deep sensory input (proprioception including limb position and kinesthesia, weight); and (3) transcutaneous electrical nerve stimulation (TENS). Stimulation parameters were: biphasic pulses; phase duration – 200 µs; pulse frequency −40 Hz; and amplitude increased at 1 mA increments up to sensory threshold or up to 40 mA if no sensation was registered by the participant (Cefar Stimulator, DJO Nordic AB, Malmo, Sweden). A home program of either explicit discrimination training or IRE using TENS was tailored according to group allocation. Participants were asked to use a TENS unit for 20 min per day for the contralesional lower extremity: ESR participants' significant other or caretaker was trained to perform ESR using the TENS unit. IRE participants operated TENS themselves or with aid of a caretaker where needed.
Uphill treadmill walking plus physical therapy versus physical therapy alone in the management of individuals with knee osteoarthritis: a randomized clinical trial
Published in Disability and Rehabilitation, 2021
Parisa Sedaghatnezhad, Mohsen Shams, Noureddin Karimi, Leila Rahnama
Individuals in both groups attended the treatment five times per week for two consecutive weeks, for a total of 10 sessions as follows: A 210B ultrasound (US, Novin Co., Isfahan, Iran) was used for continuous US therapy. A 1-MHz US head was selected; intensity was set to 1 w/cm2 [28]. Ultrasound was applied around the knee joint for 6 min (3 min anteromedial and 3 min posterior of the knee). A transcutaneous electrical nerve stimulation unit (TENS, 620 F, Novin Co., Isfahan, Iran) was then used to administer TENS therapy for 20 min. The frequency of the TENS unit was set to 100 Hz, and the pulse duration was set to 50 µs [29]. The electrodes were placed around the painful areas. The intensity of the current was increased to the point where the patient felt and was comfortable. All patients received two hot packs on the anterior and posterior of the knee for 20 min along with TENS. After applying the physical agents, the muscle strengthening program was performed individually in two sets. The repetition of exercises in each set increased from 10 to 30 during the first to fifth sessions and remained at 30 repetitions throughout the remaining five sessions. Exercises included supine quadriceps setting, side lying hip abduction, and standing heel raising on two leg.
Transcutaneous electrical nerve stimulation (TENS): a review of applications in dermatology
Published in Journal of Dermatological Treatment, 2020
Michael J. Visconti, Wasim Haidari, Steven R. Feldman
A transcutaneous electrical nerve stimulation (TENS) unit is a noninvasive, inexpensive, battery-operated device that was originally designed to provide modulation of the afferent nervous system to relieve pain. By providing alternating current through cutaneous electrodes, TENS activates large-diameter afferent fibers of the nervous system (A-beta fibers), which are proposed to diminish pain neurotransmission in the spinal cord according to the gate control theory of pain (1). In addition, TENS may secondarily activate descending inhibitory signals that also reduce pain neurotransmission in the spinal cord (2,3). The use of TENS is wide-reaching; conditions that can be treated include postoperative pain, low back pain, osteoarthritis pain, diabetic peripheral neuropathy, fibromyalgia, and neuropathic pain (2).