I
NTRODUCTION
Treatment theories
1. Endorphin theory
At very low frequencies (< 10Hz), stimulation current predominantly
causes hormonal manipulation of vegetative centers in the central
nervous system. Pain-transmitting fibers are stimulated, triggering
central pain-inhibiting mechanisms and opioid release in the brain
stem or diencephalon, and the body’s own endorphins and morphi-
ne-like substances are released. These work like painkillers!
2. Gate control theory
Stimulation frequencies > 10Hz have their effect mainly in the
“dorsal horns” of the spinal cord. There, pain sensations are pre-
vented from penetrating to consciousness. Frequencies from 85 –
100 Hz to 200 – 250 Hz can trigger pain-inhibiting mechanisms
in the free nerve endings and sympathetic nerve fibers.
This is the most widespread theory.
General pain analysis
1. Intense, sharp or piercing pain
Use frequencies < 50 Hz to < 20 Hz
Select as high a pulse width as possible > 150µsec
2. Dull, throbbing pain
Use frequencies > 50 Hz (typically)
Select as wide a pulse width as possible (the pain or throbbing
must not be aggravated), that usually means a small pulse
width of < 120µS
Avoid stimulating muscles at the same time, otherwise this can
cause aching muscles!
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