Basis, indications and risk

Treatments Basis, indications and risk Patient information Postural hygiene Exercise Maintaining level of Activity Bed rest Pharmacological therapy Neuroreflexotherapy (NRTI) Spinal column surgery Surgery for Pain and Pain Clinics Vertebral manipulation Behavioral treatment Epidural injections Facet joint infections Trigger point and ligament infections Rhizotomy Corsets and lumbar belts Traction Physical therapy/physiotherapy Electromyografic Feedback TENS: Transcutaneous electrical Nerve Stimulation Shoe insoles and shoe lifts Acupunture Recommended treatments

TENS: Transcutaneous electrical nerve stimulation

It consists of stimulation of skin nerve fibers by applying a very mild electrical shock.

Objective

To decrease pain.

Theoretical base

Pain perception is only possible when specific medullar cells are activated and when their activation is transmitted to the brain.

TENS is aimed at hampering activation of these nerve cells. A very subtle electrical shock is applied. It is not intense enough to excite pain nerves, but it is intense enough to stimulate other nerve endings of the skin -named A-beta-. Their stimulation activates medullary cells -namely "layer IV neurons"- which release a substance - called "enkephaline"-. This substance affixes to pain nerves and impedes activation of the cells perceiving pain in the medulla.

If the electrical shock is too intense pain nerves are also activated, which limits the intensity of the stimuli to be applied with TENS.

Evidence of efficacy

Some of the existing recommendations based on scientific evidence state that TENS has not proven to be effective, while others, with updated information, establish that available results are inconsistent.

Risks and contraindications

There are no described risks or contraindications.

Indications

The existing recommendations based on scientific evidence do not mention TENS in the treatment of back pain.