Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2008 Dec;10(6):492-9.
doi: 10.1007/s11926-008-0080-z.

Effectiveness of transcutaneous electrical nerve stimulation for treatment of hyperalgesia and pain

Josimari M DeSantana  1 , Deirdre M Walsh, Carol Vance, Barbara A Rakel, Kathleen A Sluka
Affiliations
Review

Effectiveness of transcutaneous electrical nerve stimulation for treatment of hyperalgesia and pain

Josimari M DeSantana et al. Curr Rheumatol Rep. 2008 Dec.

Abstract

Transcutaneous electrical nerve stimulation (TENS) is a nonpharmacologic treatment for pain relief. TENS has been used to treat a variety of painful conditions. This review updates the basic and clinical science regarding the use of TENS that has been published in the past 3 years (ie, 2005-2008). Basic science studies using animal models of inflammation show changes in the peripheral nervous system, as well as in the spinal cord and descending inhibitory pathways, in response to TENS. Translational studies show mechanisms to prevent analgesic tolerance to repeated application of TENS. This review also highlights data from recent randomized, placebo-controlled trials and current systematic reviews. Clinical trials suggest that adequate dosing, particularly intensity, is critical to obtaining pain relief with TENS. Thus, evidence continues to emerge from both basic science and clinical trials supporting the use of TENS for the treatment of a variety of painful conditions while identifying strategies to increase TENS effectiveness.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Schematic diagram showing potential pathways activated by low-frequency (LF) or high-frequency (HF) transcutaneous electrical nerve stimulation (TENS). Projections from the ventrolateral periaqueductal gray (PAG) send input to the rostroventral medial medulla (RVM), which in turn projects to the spinal cord to produce analgesia. Receptors known to be involved in the analgesia produced by TENS are listed for each site. 5HT—serotonin; ASP—aspartate; GABA—γ-aminobutyric acid; GLU—glutamate; M—muscarinic receptor.
See this image and copyright information in PMC

References

    1. Sluka KA. The Neurobiology of pain and foundations for electrical stimulation. In: Robinson AJ, Snyder-Mackler L, editors. Clinical Electrophysiology. Lippincott Williams & Wilkins; Philadelphia: 2008. pp. 107–149. [• Of importanceA recent review of all the basic science mechanisms underlying TENS]
    1. Sluka KA, Deacon M, Stibal A, et al. Spinal blockade of opioid receptors prevents the analgesia produced by TENS in arthritic rats. J Pharmacol Exp Ther. 1999;289:840–846. - PubMed
    1. Kalra A, Urban MO, Sluka KA. Blockade of opioid receptors in rostral ventral medulla prevents antihyperalgesia produced by transcutaneous electrical nerve stimulation (TENS). J Pharmacol Exp Ther. 2001;298:257–263. - PubMed
    1. Sluka KA, Chandran P. Enhanced reduction in hyperalgesia by combined administration of clonidine and TENS. Pain. 2002;100:183–190. - PubMed
    1. Loeser JD, Treede RD. The Kyoto protocol of IASP Basic Pain Terminology. Pain. 2008 (in press) - PubMed