What is TENS (Transcutaneous Electrical Nerve Stimulation).

TENS produces neuromodulation through the following pathways: (1) presynaptic inhibition in the dorsal horn of the spinal cord; (2) endogenous pain control (via endorphins, enkaphalins, and dynorphins); (3) direct inhibition of an abnormally excited nerves; and (4) restoration of afferent input. The results of laboratory studies suggest that electrical stimulation delivered by a TENS unit reduces pain through nociceptive inhibition at the presynaptic level in the dorsal horn, thus limiting its central transmission. The electrical stimuli on the skin preferentially activate low- threshold myelinated nerve fibers. The afferent input from these fibers inhibits propagation of nociception carried in the small unmyelinated C fibers by blocking transmission along these fibers to the target or T cells located in the Substantia Gelatinosa (laminae 2 and 3) of the dorsal horn.

Combining Technology with Tradition to Effect Superior Pain Management Strategies

Choong Khean Foo (RMIT University, Australia)