Electrical stimulation of peripheral and central pathways for the relief of musculoskeletal pain

1991 ◽  
Vol 69 (5) ◽  
pp. 697-703 ◽  
Author(s):  
M. Catherine Bushnell ◽  
Serge Marchand ◽  
Nicole Tremblay ◽  
Gary H. Duncan
Keyword(s):  
Electrical Stimulation ◽  
Deep Brain Stimulation ◽  
Musculoskeletal Pain ◽  
Nerve Stimulation ◽  
Transcutaneous Electrical Nerve Stimulation ◽  
Dorsal Column ◽  
Electrical Nerve Stimulation ◽  
Dorsal Column Stimulation ◽  
Deep Brain ◽  
Stimulation Of

One method for the treatment of chronic musculoskeletal pain involves stimulation of the peripheral or central nervous system. Such stimulation includes transcutaneous electrical nerve stimulation, dorsal column stimulation, and deep brain stimulation. This review discusses the clinical use of electrical stimulation for the relief of musculoskeletal pain, and describes the results of studies conducted in our laboratory suggesting that such stimulation reduces pain transmission along sensory-discriminative pathways.Key words: pain, nociception, transcutaneous electrical nerve stimulation, dorsal column stimulation, deep brain stimulation.

scholarly journals Deep Brain Stimulation of the Posterior Insula in Chronic Pain: A Theoretical Framework

2021 ◽  
Vol 11 (5) ◽  
pp. 639
Author(s):  
David Bergeron ◽  
Sami Obaid ◽  
Marie-Pierre Fournier-Gosselin ◽  
Alain Bouthillier ◽  
Dang Khoa Nguyen
Keyword(s):  
Chronic Pain ◽  
Electrical Stimulation ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
High Frequency ◽  
Brain Lesion ◽  
Low Frequency ◽  
Posterior Insula ◽  
Deep Brain ◽  
Stimulation Of

Introduction: To date, clinical trials of deep brain stimulation (DBS) for refractory chronic pain have yielded unsatisfying results. Recent evidence suggests that the posterior insula may represent a promising DBS target for this indication. Methods: We present a narrative review highlighting the theoretical basis of posterior insula DBS in patients with chronic pain. Results: Neuroanatomical studies identified the posterior insula as an important cortical relay center for pain and interoception. Intracranial neuronal recordings showed that the earliest response to painful laser stimulation occurs in the posterior insula. The posterior insula is one of the only regions in the brain whose low-frequency electrical stimulation can elicit painful sensations. Most chronic pain syndromes, such as fibromyalgia, had abnormal functional connectivity of the posterior insula on functional imaging. Finally, preliminary results indicated that high-frequency electrical stimulation of the posterior insula can acutely increase pain thresholds. Conclusion: In light of the converging evidence from neuroanatomical, brain lesion, neuroimaging, and intracranial recording and stimulation as well as non-invasive stimulation studies, it appears that the insula is a critical hub for central integration and processing of painful stimuli, whose high-frequency electrical stimulation has the potential to relieve patients from the sensory and affective burden of chronic pain.

scholarly journals Stretch Reflex Latencies in Spastic Hemiparetic Subjects are Prolonged After Transcutaneous Electrical Nerve Stimulation

1993 ◽  
Vol 20 (2) ◽  
pp. 97-106 ◽  
Author(s):  
Christina W.Y. Hui-Chan ◽  
Mindy F. Levin
Keyword(s):  
Nerve Stimulation ◽  
Transcutaneous Electrical Nerve Stimulation ◽  
Stretch Reflex ◽  
Time Course ◽  
Dorsal Column ◽  
Electrical Nerve Stimulation ◽  
Reflex Excitability ◽  
Reflex Threshold ◽  
Repetitive Electrical Stimulation

ABSTRACT:Low-intensity repetitive electrical stimulation such as dorsal column and transcutaneous electrical nerve stimulation (TENS) reportedly decreases spasticity and improves voluntary motor control. However, the mechanisms mediating these effects are unclear. Recent findings suggest that spasticity may be characterized more appropriately by a decrease in the stretch reflex threshold than by an increase in gain. Our objectives were: (1) to examine possible changes in stretch reflex excitability following 45 min of TENS, (2) to map out the time course of possible post-stimulation effects via both latency and magnitude (amplitude or area) measurements, and (3) to determine the role of segmental versus non-segmental mechanisms involved in mediating these changes. The effects of 45 min of segmentally and heterosegmentally applied TENS on lower limb reflexes in ten spastic hemiparetic subjects were contrasted with those resulting from placebo stimulation. We found that both segmentally and heterosegmentally applied TENS caused an immediate increase in soleus H reflex latencies that was evident for up to 60 minutes post-stimulation in over 75% of the subjects. Similar increases for up to 60 and 40 minutes post-stimulation was noted for the stretch reflex latencies in 50% and 67% of the subjects respectively for segmental and heterosegmental stimulation. These results suggested that manipulation of segmental and heterosegmental afférents for 45 min may lead to a decrease of the otherwise augmented stretch reflex excitability accompanying hemiparetic spasticity.

Treatment of idiopathic head drop (camptocephalia) by deep brain stimulation of the globus pallidus internus

2009 ◽  
Vol 110 (6) ◽  
pp. 1271-1273 ◽  
Author(s):  
Damianos E. Sakas ◽  
Ioannis G. Panourias ◽  
Efstathios J. Boviatsis ◽  
Marios S. Themistocleous ◽  
Lambis C. Stavrinou ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Deep Brain Stimulation ◽  
Globus Pallidus ◽  
Brain Stimulation ◽  
Globus Pallidus Internus ◽  
Number Of Patients ◽  
Chronic Electrical Stimulation ◽  
Lying Down ◽  
Deep Brain ◽  
Stimulation Of

Deep brain stimulation of the globus pallidus internus has been shown to be beneficial in a small number of patients suffering from axial dystonias. However, it has not yet been reported as an effective treatment for the alleviation of idiopathic head drop. The authors describe a 49-year-old woman with idiopathic cervical dystonia (camptocephalia) who was unable to raise her head > 30° when standing or sitting; her symptoms would abate when lying down. This disabling neurological condition was treated successfully with bilateral chronic electrical stimulation of the globus pallidus internus.

scholarly journals Problems, Solutions, and Strategies Reported by Users of Transcutaneous Electrical Nerve Stimulation for Chronic Musculoskeletal Pain: Qualitative Exploration Using Patient Interviews

2016 ◽  
Vol 96 (7) ◽  
pp. 1039-1048 ◽  
Author(s):  
Peter William Gladwell ◽  
Kathryn Badlan ◽  
Fiona Cramp ◽  
Shea Palmer
Keyword(s):  
Clinical Practice ◽  
Data Analysis ◽  
Musculoskeletal Pain ◽  
Nerve Stimulation ◽  
Transcutaneous Electrical Nerve Stimulation ◽  
Chronic Musculoskeletal Pain ◽  
Pain Clinic ◽  
Electrical Nerve Stimulation ◽  
Primary Data Analysis ◽  
Semistructured Interviews

Abstract Background Transcutaneous electrical nerve stimulation (TENS) could offer a non-drug form of pain relief, but there is no consensus regarding its effectiveness for chronic musculoskeletal pain or chronic low back pain. A recent review of previous trial methods identified significant problems with low treatment fidelity. There is little information available to inform the development of a pragmatic implementation design for a TENS evaluation. Objectives The aim of this study was to explore the experiences of patients who were receiving secondary care in a pain clinic and who had expertise in using TENS to manage chronic musculoskeletal pain. These key informants were selected because they had the potential to generate knowledge that could inform research design and clinical practice. Design A qualitative method using individual semistructured interviews with open questions was selected for its capacity to generate rich data. Methods Semistructured interviews were conducted with 9 patients (6 women, 3 men). Thematic analysis was used as the primary data analysis method, and this analysis was enhanced by a case-level analysis of the context and processes of TENS use of each individual. Results Data analysis indicated that patients learned to address a range of problems in order to optimize TENS use. Patients may need to personalize the positioning of electrodes and the TENS settings and to readjust them over time. Patients learned to use TENS in a strategic manner, and the outcomes of each strategy varied. Conclusions The findings indicated that a pragmatic TENS evaluation may need to incorporate a learning phase to allow patients to optimize this complex pattern of TENS usage, and evaluation may need to be sensitive to the outcomes of strategic use. These findings also have implications for clinical practice.

scholarly journals Effect of low frequency transcutaneous electrical nerve stimulation of TE5 (waiguan) and PC6 (neiguan) acupoints on cold-induced pain

2016 ◽  
Vol 28 (1) ◽  
pp. 76-81 ◽  
Author(s):  
Eduardo José Nepomuceno Montenegro ◽  
Geisa Guimarães de Alencar ◽  
Gisela Rocha de Siqueira ◽  
Marcelo Renato Guerino ◽  
Juliana Netto Maia ◽  
...  
Keyword(s):  
Nerve Stimulation ◽  
Transcutaneous Electrical Nerve Stimulation ◽  
Low Frequency ◽  
Electrical Nerve Stimulation ◽  
Stimulation Of

scholarly journals Effectiveness of Transcutaneous Electrical Nerve Stimulation with Taping for Stroke Rehabilitation

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Tae-Sung In ◽  
Jin-Hwa Jung ◽  
Kyoung-Sim Jung ◽  
Hwi-Young Cho
Keyword(s):  
Electrical Stimulation ◽  
Muscle Strength ◽  
Nerve Stimulation ◽  
Transcutaneous Electrical Nerve Stimulation ◽  
Plantar Flexors ◽  
Stroke Patients ◽  
Noninvasive Methods ◽  
Electrical Nerve Stimulation ◽  
Functional Training ◽  
Long Term Follow Up

Background. Spasticity is a factor that impairs the independent functional ability of stroke patients, and noninvasive methods such as electrical stimulation or taping have been reported to have antispastic effects. The purpose of this study was to investigate the effects of transcutaneous electrical nerve stimulation (TENS) combined with taping on spasticity, muscle strength, and gait ability in stroke patients. Methods. From July to October 2020, 46 stroke patients with moderate spasticity in the plantar flexors participated and were randomly assigned to the TENS group ( n = 23 ) and the TENS+taping group ( n = 23 ). All subjects performed a total of 30 sessions of functional training for 30 min/session, 5 days/week, for 6 weeks. For therapeutic exercise, sit-to-standing, indoor walking, and stair walking were performed for 10 min each. In addition, all participants in both groups received TENS stimulation around the peroneal nerve for 30 min before performing functional training. In the TENS+taping group, taping was additionally applied to the feet, ankles, and shin area after TENS, and the taping was replaced once a day. The composite spasticity score and handheld dynamometer measurements were used to assess the intensity of spasticity and muscle strength, respectively. Gait ability was measured using a 10 m walk test. Results. The spasticity score and muscle strength were significantly improved in the TENS+taping group compared to those in the TENS group ( p < 0.05 ). A significant improvement in gait speed was observed in the TENS+taping group relative to that in the TENS group ( p < 0.05 ). Conclusions. Thus, TENS combined with taping may be useful in improving spasticity, muscle strength, and gait ability in stroke patients. Based on these results, an additional application of taping could be used to enhance the antispastic effect of TENS or other electrical stimulation treatments in the clinic. A long-term follow-up study is needed to determine whether the spasticity relieving effect persists after taping is removed.

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