The effectiveness of transcutaneous electrical nerve stimulation in the management of patients with complex regional pain syndrome: A randomized, double-blinded, placebo-controlled prospective study

2016 ◽  
Vol 29 (4) ◽  
pp. 661-671 ◽  
Author(s):  
Adem Bilgili ◽  
Tuncay Çakır ◽  
Şebnem Koldaş Doğan ◽  
Tülay Erçalık ◽  
Meral Bilgilisoy Filiz ◽  
...  
Keyword(s):  
Prospective Study ◽  
Complex Regional Pain Syndrome ◽  
Nerve Stimulation ◽  
Transcutaneous Electrical Nerve Stimulation ◽  
Pain Syndrome ◽  
Electrical Nerve Stimulation ◽  
Double Blinded

scholarly journals Transcutaneous Electrical Nerve Stimulation for the Management of Neuropathic Pain: The Effects of Frequency and Electrode Position on Prevention of Allodynia in a Rat Model of Complex Regional Pain Syndrome Type II

2006 ◽  
Vol 86 (5) ◽  
pp. 698-709 ◽  
Author(s):  
David L Somers ◽  
F Richard Clemente
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Nerve Stimulation ◽  
High Frequency ◽  
Transcutaneous Electrical Nerve Stimulation ◽  
Low Frequency ◽  
Pain Syndrome ◽  
Syndrome Type ◽  
Type Ii ◽  
Electrical Nerve Stimulation ◽  
The Right

Abstract Background and Purpose. Complex regional pain syndrome type II (CPSII) is a painful condition that develops following a nerve injury. Although transcutaneous electrical nerve stimulation (TENS) relieves the pain of CPSII, the stimulation parameters that would best prevent the development of the condition are not known. The purpose of this study was to compare the ability of several different stimulation strategies to reduce the development of allodynia. Subjects. Sprague-Dawley rats were used in the study. Methods. A chronic constriction injury (CCI) to the right sciatic nerve was used to induce allodynia. Two groups of CCI rats received high-frequency TENS to the lumbar paravertebral region with electrodes positioned on the skin overlying either the right or left paraspinal musculature. Two additional groups of CCI rats received low-frequency TENS to acupuncture points in the right or left hind limbs. A fifth group of CCI rats received no TENS intervention. Thermal and mechanical pain thresholds were assessed in the right hind paw before and 12 days after the CCI surgery. The TENS was delivered 1 hour per day beginning on the day of surgery. Results. Daily high-frequency TENS reduced the development of mechanical allodynia in CCI rats, and low-frequency TENS reduced the development of thermal allodynia, but only when TENS was delivered on the left side. Discussion and Conclusion. The results indicate that TENS delivered contralateral to a nerve injury best reduces allodynia development. Comprehensive reduction of allodynia development would require a combination of high- and low-frequency TENS intervention.

scholarly journals Transcutaneous electrical nerve stimulation using an LTP-like repetitive stimulation protocol for patients with upper limb complex regional pain syndrome: A feasibility study

Hand Therapy ◽  
2016 ◽  
Vol 22 (2) ◽  
pp. 52-63 ◽  
Author(s):  
CG Ryan ◽  
R King ◽  
V Robinson ◽  
TD Punt ◽  
HR Dinse ◽  
...  
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Upper Limb ◽  
Nerve Stimulation ◽  
Transcutaneous Electrical Nerve Stimulation ◽  
Controlled Trial ◽  
Pain Syndrome ◽  
Long Term Potentiation ◽  
Stimulation Protocol ◽  
Electrical Nerve Stimulation ◽  
Randomised Controlled

Introduction This feasibility study aimed to (i) develop a clinical protocol using a long-term potentiation-like repetitive stimulation protocol for transcutaneous electrical nerve stimulation in patients with upper limb complex regional pain syndrome and (ii) develop a research protocol for a single-blind randomised controlled trial investigating the efficacy of transcutaneous electrical nerve stimulation for complex regional pain syndrome. Methods This small-scale single-blind feasibility randomised-controlled trial planned to randomise 30 patients with upper limb complex regional pain syndrome to either a variant of transcutaneous electrical nerve stimulation or placebo transcutaneous electrical nerve stimulation for three weeks. Stimulation comprised 20 pulses over 1 s with a non-stimulation interval of 5 s, a so-called repetitive electrical stimulation protocol following the timing of long-term potentiation. Pain, function and body image were measured at baseline, post-treatment and at three months follow-up. At three months, participants were invited to one-to-one interviews, which were analysed thematically. Results A transcutaneous electrical nerve stimulation protocol with electrodes applied proximal to the area of allodynia in the region of the upper arm was developed. Participant concordance with the protocol was high. Recruitment was below target (transcutaneous electrical nerve stimulation (n = 6), placebo (n = 2)). Mean (SD) pain intensity for the transcutaneous electrical nerve stimulation group on a 0 to 10 scale was 7.2 (2.4), 6.6 (2.8) and 7.8 (1.9), at baseline, post-treatment and at three-month follow-up, respectively. Qualitative data suggested that some patients found transcutaneous electrical nerve stimulation beneficial, easy to use and were still using it at three months. Conclusion Patients tolerated transcutaneous electrical nerve stimulation well, and important methodological information to facilitate the design of a large-scale trial was obtained (ISRCTN48768534).

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