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Tens
Transcutaneous Electrical Nerve Stimulation (TENS) is a selective stimulation of the
large fibers of the peripheral nerves favoring the closing of the gate entrance for
the pain pulses and increasing the release of endorphinic substances, reducing in
this way the pain intensity. Therefore, with TENS we want to treat the severe and
chronic pain due to the main musculoskeletal pains.
The pain decrease following to the TENS currents application is due to these factors:
a. Gate control theory
b. Endorphin secretion
c. Different sedative effects in relation with the frequency
Gate theory
If the electric signals that lead to the brain information about pain are stopped, also
the pain perception is eliminated. If, for instance, we hit our head into an object the
first thing we do is massaging the area affected by the trauma. In this way we
stimulate the receptors related to touch and pressure. TENS in continuous mode and
in frequency modulation can be used to generate signals similar to the ones of
touch and pressure. If their intensity is enough, their priority is so high that it prevails
on the pain signals. Once the priority is gained, the gate related to the sensory
signals is opened and the pain one is closed, impeding in this way the passage of
these signals to the brain.
Endorphin secretion
When a nervous signal proceeds from the pain area to the brain, it spreads through
a chain of connections joined together called synapse. The synapse can be seen
as the space between the end of a nerve and the start of another. When an
electric signal reaches the end of a nerve, it produces some substances called
neurotransmitters that pass through the synapse and activate the start of the next
nerve. This process repeats for all the length needed to the signal to reach the
brain. The opioids involved in the pain reduction have the task to insinuate in the
synapse space and impede the neurotransmitter propagation. In this way a
chemical block of the pain signals occurs. The endorphins are opioids naturally
produced by the body to tackle the pain and they can act both on the marrow
and on the brain, in this way they are effective analgesics. Tens can increase the
natural production of endorphins and, thereby, they act decreasing the pain
perception.
Different effects in relation with the frequency
Depending on the frequency used, it can occur antalgic effects of immediate
effect but with no long duration (higher frequencies), or more progressive effects
but also longer in time (low frequencies).
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