TENS: replacement of analgesics for arthritis

If you have suffered from arthritis at any time, your doctor has definitely talked to you through a list of pain relief options: skin patches or oral, injections, physical therapy, hot, cold and Acupuncture is just a few of the ways to make your arthritis more pleasant. However, the pain relief solution for arthritis does not stop there.

Neurological stimulation - or neurological treatment - is an alternative to medicine for treating arthritis pain.

For some people, neurological treatments can relieve pain with minimal risks.

These devices are usually safe. However, they involve sending electrical impulses through your body. Therefore, it is important to talk to your doctor first, if you have a pacemaker, another implant, are pregnant, have seizures or have heart problems.

Transcutaneous Electrical Nerve Stimulation (TENS) - for arthritis

What is TENS?
TENS uses electrodes, which are attached to a small battery-powered device. It sends an electric current to your nerves to override pain signals. Therefore, TENS can reduce pain by activating the release of natural painkillers (endorphin) in the brain. TENS can be distributed at low frequency (l-TENS) or high frequency (h-TENS) - the controller allows you to select the frequency you prefer.

Portable TENS unit - TENS and EMS are integrated:



Activity for arthritis:
TENS has been shown to reduce joint pain (arthritis) and reduce the need for painkillers. A review of the Cochrane Presidential Review 2015 concluded: there is evidence that TENS reduces the intensity of pain more and higher than placebo. TENS helps relieve acute (short-term) and chronic pain (long-term). Since reading the document, Dr. Bolash estimates that, in general, about half of TENS users have reduced their pain by 50%.

Stimulation patterns of TENS for arthritis

Pulsed Electrical Stimulation (PES)

PES delivers a current to the site of pain via electrodes placed on the skin. In theory, it treats arthritis damage by rebuilding and repairing joint cartilage.

Research on PES for arthritis has been mixed. A 2013 analysis published in Osteoarthritis and Cartilage found a few studies in which PES improved knee OA pain and reduced the need for NSAIDs, but they weren’t well designed. Another more rigorous study published in 2011 in Arthritis & Rheumatism found PES wasn’t any more effective for pain relief than a placebo.

Neuromuscular Electrostimulation (NMES)

NMES applies electrical impulses to nerves to make the muscles contract. It used for people with arthritis  to strengthen the muscles that support weakened joints.

Some studies show NMES can help offset the muscle weakness found in people with knee OA. A small 2012 study published in Journal of Orthopaedic Research found that quadriceps strength and overall health status improved in people with knee OA after using NMES for 8 weeks.

Interferential Current (IFC)

IFC transmits two different frequency currents to help the energy reach deeper into the tissues. The deep-penetrating current is thought to block the transmission of pain signals or stimulate the release of natural pain-relieving chemicals in the body.

Research shows IFC is better than placebo at relieving knee OA pain. In a 2015 review of studies published in Osteoarthritis & Cartilage, IFC performed better than other electrical nerve stimulation techniques.

Noninvasive Interactive Neurostimulation (NIN)

The NIN device delivers high-amplitude impulses into the skin. These impulses are believed to trigger the release of chemicals that reduce pain and inflammation.

In a small preliminary study from 2008 published in Journal of Alternative and Complementary Medicine, people with knee OA had less pain after using NIN.

Spinal Cord Stimulation

Spinal cord stimulation uses a wire that’s surgically implanted under your skin to deliver an electrical current directly to your spinal cord. The current blocks pain signals before they can reach your brain. This technique offers long-lasting pain relief, “and the opportunity for patients to liberate themselves from the pain clinic,” Dr. Bolash says.

A 2014 literature review published in Pain Physician summarized that spinal cord stimulation can be effective for treating chronic pain of the torso and limbs, intractable low back pain, leg pain, and pain from failed back surgery.

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