The effects of transcutaneous electrical nerve stimulation on experimental pain and sympathetic nervous system response

Abstract

Objective. Transcutaneous electrical nerve stimulation (TENS) is a technique widely used in clinical practice to control pain, although its clinical efficacy remains controversial. Though many mechanisms have been proposed for its analgesic effects, there is a conspicuous lack of experimentally controlled research investigating whether TENS analgesia is related to its effects on the sympathetic nervous system (SNS). Methods. Using an established psychophysiological paradigm, the present study investigated the effects of high-frequency/low-intensity TENS, low-frequency/high-intensity TENS, and sham TENS on the perception of experimental pain and SNS function in healthy volunteers. Measures of heart rate, digital pulse volume, and skin conductance were recorded during a 20-minute TENS stimulation period and in anticipation of a series of painful electric shocks prior to and following TENS stimulation. Healthy volunteers rated the intensity of the shocks using a 0-10-point verbal pain rating scale. Results. The three TENS conditions failed to differentially effect SNS responses during either the 20-minute TENS treatment period or the shock anticipation periods, and TENS did not affect ratings of pain intensity to the shock stimuli. Conclusions. While these results may not generalize to acute or chronic pain patients, within the limitations of the present experimental paradigm, no support was found for TENS affecting either SNS function or acute experimental pain perception. © American Academy of Pain Medicine.