ELECTRICAL PAIN RELIEF

• Acute Pain Relief
• Chronic Pain Management
• The Medication Effect of Endorphins
• Unlearning Pain
  

Electrical Pain Relief is achieved by applying a treatment known as TENS, whilst the equipment used to apply TENS therapy is known as a TENS system. TENS is able to "switch-off" or considerably reduce the feeling of pain. It does this by working in two ways.

The first is by sending masses of sensory messages to the brain, which becomes flooded with sensory feelings that are perceived to be of more importance than the feeling of pain. This is commonly known as a 'Gating Effect' (a metaphorical pain control gate is closed, "locking out" the pain).

The second way is caused by a hormonal release of Encephalins and Endorphins due to a raised level of brain activity. Encephalins are quickly released, but only remain active for a short period. Endorphins are slowly released and may take up to 30 minutes to take effect, but remain active for a long 8 to 36 hour period. An endorphin release has a strong influence on controlling chronic pain, as it can manage intractable pain that does not respond to non-opiate medication.

Modern TENS devices can effectively treat pain using a mixture of a high pulse rate stimulation used for a gating effect and an Encephalins release, with a low pulse rate used for an endorphin release.

Electrical therapy to alleviate acute pain is used for periods of application up to 20 minutes duration, at a rate of 100 pulses per second, applied to regions of pain. This causes a Gating Effect, or a blocking of the signals of pain travelling from the area of injury to the brain. A gating effect provides pain relief for a short period of approximately 2 hours.

Sometimes, an exception to short treatments is needed for relief from very strong, acute pain. For this purpose, extended treatment periods are needed to sustain a strong gating effect, and if necessary the treatment can be continuously applied until the pain has subsided. The rapid relief from pain that is achieved enables early mobilizing exercises, which removes the pressure on nerve tissue to quickly eliminate the cause of the pain. i.e. - a severe attack of acute low back pain.

* Gating Effect - This term is used to explain the blocking of pain perception, when a metaphorical "Pain Control Gate" shuts off pain perception from registering in the Central Nervous System (CNS).

A highly elevated endorphin release provides pain relief for a period of 8-36 hours. For adequate pain relief use 1-2 hour doses, which may be required to be repeated 3-4 times weekly to 3 times daily, at a low to medium pulse rate. Sometimes an endorphin release is not strong enough, or is slow to take effect. Using a high pulse rate and then applying continuous stimulation will help to remedy this.

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Sustained stimulation at low levels of pulse intensity, at a low pulse rate has the strongest effect on managing chronic nagging pain. Experience has shown that for the management of chronic pain, an endorphin release is by far the most effective application of TENS. Endorphins flow through the circulatory system acting like pain medication, inhibiting pain message transmission at nerve junctions throughout the body. Because the analgesic effect is distributed within the blood stream, relief is also achieved from other aches and pains, as well as the primary pain for which TENS was applied.

It is worth noting that morphine is a clone of endorphin and acts on the same reception centre in the CNS. The strong pain management effect of morphine is also available from endorphins, which have a more powerful pain management effect than non-opiate medication.

An endorphin release works similar in effect to pharmaceutical medication so repeated doses of TENS, three times daily (like medication) can often be required. The level of Endorphins may be stimulated to a three-fold level of normal concentration. These concentrated levels remain in the blood stream for longer periods.

To simultaneously achieve both a gating effect and an endorphin release the stimulation is applied at a modulated (changing frequency) high-low pulse rate. This modulation is not as easily adapted to as a constant rate of stimulation.

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This is a complex mechanism, and is poorly understood, although it does appear that with repeated doses of TENS applied prior to the return of the pain, there is a sustained loss of the of pain perception. This perception is transmitted to the brain in the ascending sensory neural tracts in the dorsal columns* of the spinal cord.

After a course of treatment with TENS, the body can be 'reprogrammed' so that pain is no longer perceived - it has been taught to "unlearn the pain".

* See Dorsal Column Implants