Transcutaneous Electrical Nerve Stimulation for Facial Pain.

Several studies find that manual acupuncture and transcutaneous electrical nerve stimulation (TENS) are via different mechanisms and generate different effect on the central nervous system, therefore, the aim of the present study was to compare the effect of manual acupuncture (MA) and TENS on the spinal cord using H-reflex recordings. A total of 13 healthy adult volunteers were studied. The electrical stimuli were delivered to the posterior tibial nerve transcutaneously at the left popliteal fossa to evoke the soleus H-reflex. MA, 2Hz TENS, 100 Hz TENS, respectively, was applied to the surface of the right first dorsal interosseous muscle exactly at the Hegu acupoint (LI.4). Four assessments were performed randomly, separated by an interval of at least three days in all the subjects as follows: 1) Control assessment: a pair of electrodes placed on the surface of the right Hegu acupoint (LI.4), but no electrical stimulation was delivered throughout the test; 2) MA assessment: MA was done at the right Hegu acupoint (LI.4) for 15 minutes; 3) TENS assessment at 2Hz: electrical stimulation (40 mA in intensity) at 2Hz was applied to the surface of the right Hegu acupoint (LI.4) for 15 minutes; 4) TENS assessment at 100 Hz: electrical stimulation (20 mA in intensity) at 100 Hz was applied to the surface of the right Hegu acupoint (LI.4) for 15 minutes. Each assessment was divided into three periods as follows: 1) Baseline period: H-reflexes recorded prior to MA or TENS; 2) TENS period: six H-reflex recordings after MA or TENS for a duration of 4-5 min, 9-10 min and 14-15 min, respectively; 3) Post TENS period: H-reflex recordings of 6 after TENS period 4-5 min and 9-10 min, respectively. Our results indicate that both 2Hz TENS and 100 Hz TENS increased the amplitude of the H-reflex, and that these increases may be retained longer with 100 Hz TENS than with 2 Hz TENS, whereas MA could not increase the amplitude of the H-reflex. MA, TENS at 2 Hz or 100 Hz didn't change the latencies of the H-reflexes. We conclude that both 2Hz and 100 Hz TENS increased the amplitude of the H-reflex, suggesting that TENS enhances the excitability of the motoneuron pool in the spinal cord, and 100 Hz TENS has a greater effect than 2Hz TENS, whereas MA was not similar effect to TENS on spinal cord.

Introduction: Temporomandibular joint disorders (TMDs) are the most common source of pain on the face. There are multiple etiologies, and several types of treatment have been reported. The use of non-invasive and reversible therapies in the treatment of such problems is recommended. The present study evaluated the effect of low-level laser (LLL) therapy and transcutaneous electric nerve stimulation (TENS) on TMDs. Methods: In this single-blind study, 40 patients with temporomandibular disorders were randomly divided into four groups: TENS (TENSTem dental), LLL (diode 810 nm CW), shamTENS, and sham-LLL. All subjects were examined and data on pain and tenderness in the temporomandibular joint (TMJ) and masticatory muscles (using the visual analogue scale) and mouth-opening (distance between incisal edges before feeling pain; mm) were collected before baseline (T1), after each session (T2-T5) and one month after the end of the sessions (T6)), and analyzed using repeated measure analysis of variance (ANOVA) and Bonferroni statistical tests. A P value < 0.05 was considered significant. Results: The decrease in pain (P=0.000), tenderness (P=0.000) and increase in mouth-opening ability (P=0.002) was greater in the TENS and LLL groups than in the placebo groups. At the one-month follow-up, significant decrease in pain and tenderness was recorded in the TENS and LLL groups (P=0.000). There was no significant differences between TENS and LLL and the placebo groups for maximum mouth-opening at the end of the study (P=0.692). Conclusion: Using TENS or LLL therapy can improve TMD symptoms at least for the short term. Although the effects of the placebo played a role in improving symptoms, their effects were less important.

Comparison of the Effects of Transcutaneous Electrical Nerve Stimulation and Low-Level Laser Therapy on Drug-Resistant Temporomandibular Disorders

Transcutaneous electrical nerve stimulation (TENS) is a non-invasive treatment modality for acute and chronic pain. However, little information for muscle activity is available on the immediate effects of TENS in masticatory muscle pain related to temporomandibular disorders (TMDs). The present study aimed to evaluate the immediate effects of TENS treatment on TMD-related muscle pain. Thirty-six patients with TMD-related muscle pain and 39 healthy subjects served as TMD and control groups, respectively. For objective evaluations, maximum mouth opening, and maximum bite force were measured before and after TENS. The pain intensity was assessed according to a 100-mm visual analog scale (VAS). TENS was applied to painful muscles for 20 min with frequencies of 100–200 Hz. The treatment outcome was evaluated using Global Rating of Change (GRC) scales. In the TMD group, VAS values significantly decreased after TENS. Although there was significant increase in the maximum mouth opening after TENS for only TMD group, the maximum bite force of both groups was significantly greater after TENS. According to GRC scales, one patient with TMD-related muscle pain expressed negative feelings after TENS. Conclusively, TENS treatment might quickly relieve pain in masticatory muscles and improve masticatory functions in patients with TMD-related muscle pain.

Differential diagnosis of facial pain and guidelines for management

Systematic review and meta-analysis on the role of transcutaneous electrical nerve stimulation in children with overactive bladder - Pooled analysis of nine randomized controlled trials.

Objective Summarize the evidence from randomized controlled trials and controlled trials that examined the effectiveness of electrotherapy in the treatment of patients with orofacial pain. Data Source Medline, Embase, CINAHL PLUS with Full text, Cochrane Library Trials, Web of Science, and Scopus. Review Methods A data search (last update, July 1, 2022) and a manual search were performed (October 5, 2022). Trials involving adults with orofacial pain receiving electrotherapy compared with any other type of treatment were included. The main outcome was pain intensity; secondary outcomes were mouth opening and tenderness. The reporting was based on the new PRISMA Guidelines. Results From the electronics databases and manual search 43 studies were included. Although this study was open to including any type of orofacial pain, only studies that investigated temporomandibular disorders were found. The overall quality of the evidence for pain intensity was very low. Although the results should be carefully used, transcutaneous electric nerve stimulation therapy showed to be clinically superior to placebo for reducing pain after treatment (2.63 [−0.48; 5.74]) and at follow-up (0.96 [−0.02; 1.95]) and reduce tenderness after treatment (1.99 [−0.33; 4.32]) and at follow-up (2.43 [−0.24; 5.10]) in subjects with mixed temporomandibular disorders. Conclusion The results of this systematic review support the use of transcutaneous electric nerve stimulation therapy for patients with mixed temporomandibular disorders to improve pain intensity, and tenderness demonstrating that transcutaneous electric nerve stimulation is superior to placebo. There is inconsistent evidence supporting the superiority of transcutaneous electric nerve stimulation against other therapies.

Hypoalgesic Effect of the Transcutaneous Electrical Nerve Stimulation Following Inguinal Herniorrhaphy: A Randomized, Controlled Trial

Spasticity management is pivotal for achieving functional recovery of stroke patients. The purpose of this study was to investigate the effects of a single trial of transcutaneous electrical nerve stimulation (TENS) on spasticity and balance in chronic stroke patients. Forty-two chronic stroke patients were randomly allocated into the TENS (n = 22) or the placebo-TENS (n = 20) group. TENS stimulation was applied to the gastrocnemius for 60 min at 100 Hz, 200 µs with 2 to 3 times the sensory threshold (the minimal threshold in detecting electrical stimulation for subjects) after received physical therapy for 30 min. In the placebo-TENS group, electrodes were placed but no electrical stimulation was administered. For measuring spasticity, the resistance encountered during passive muscle stretching of ankle joint was assessed using the Modified Ashworth Scale, and the Hand held dynamometer was used to assess the resistive force caused by spasticity. Balance ability was measured using a force platform that measures postural sway generated by postural imbalance. The TENS group showed a significantly greater reduction in spasticity of the gastrocnemius, compared to the placebo-TENS group (p < 0.05). TENS resulted in greater balance ability improvements, especially during the eyes closed condition (p < 0.05). However, these effects returned to baseline values within one day. This study shows that TENS provides an immediately effective means of reducing spasticity and of improving balance in chronic stroke patients. The present data may be useful to establish the standard parameters for TENS application in the clinical setting of stroke.

Effects of thermotherapy and transcutaneous electrical nerve stimulation on patients with primary dysmenorrhea: A randomized, placebo-controlled, double-blind clinical trial

Transcutaneous electrical nerve stimulation or TENS is a nonpharmacologic method that is used to alleviate pain from various acute and chronic conditions. TENS works through activation of descending inhibitory neurons of the central nervous system. In dentistry, TENS has applications for pain reduction in temporomandibular disorders and postherpetic neuralgia. It has also been studied for its role in increasing salivary secretion in subjects with xerostomia and as a local anesthetic agent in pediatric dentistry. Its wide applications in the orofacial region make it an important treatment modality. The purpose of the present review was to describe the general principles and its applications in dentistry along with its indications, advantages, and disadvantages. A web-based search was conducted using the keywords “transcutaneous electrical nerve stimulation,” “temporomandibular joint,” “TENS,” “TMJ,” “orofacial pain,” and “Management.” The manuscripts thus obtained were evaluated and used for compiling the present narrative review. The present review focuses on the mechanism of action, applications, and effectiveness of TENS in the management of diseases of the maxillofacial region.

Background: Transcutaneous electrical nerve stimulation (TENS) is presently one of the main methods of treatment for neuropathic pain in type II diabetes mellitus. The discussion about which TENS frequency is more effective in the treatment of neuropathic pain has been ongoing for many years. Despite this, the response of different aspects of neuropathic pain to various TENS modalities has not been sufficiently studied. Aim: To analyze changes in characteristics of neuropathic pain depending on the frequency of TENS. Materials and methods: Seventy-five Russian diabetic patients with painful distal axonal neuropathy were enrolled in the study. Patients were assigned to three groups: in the HF TENS group, 25 patients received standard drug therapy (Alpha-lipoic acid, Pentoxifylline, Vitamin B12, Gabapentin) + high-frequency TENS (HF); in the LF TENS group, 25 patients received standard drug therapy (Alpha-lipoic acid, Pentoxifylline, Vitamin B12, Gabapentin) + low-frequency TENS (LF); in the control group, 25 patients underwent just standard drug therapy (Alpha-lipoic acid, Pentoxifylline, Vitamin B12, Gabapentin). Pain intensity was calculated before and after treatment with visual analogue scale (VAS), McGill pain questionnaire (MPQ), Douleur Neuropathique 4 Questions (DN4) and Pain Drawing. Results: TENS increased the therapeutic effect of standard drug therapy, in the treatment of neuropathic pain, by 65.9% and prolonged its efficacy by 31% for up to 6 months after treatment. HF TENS had a more pronounced analgesic effect than LF TENS based on VAS (34.7%), sensory (57.6%) MPQ dimensions and DN4 (21%). Affective MPQ dimension with the use of LF TENS was lower than HF TENS by 34.7% immediately after treatment, by 47.3% after 2 months and by 34.8% after 6 months of the follow-up period. Conclusion: There are significant differences between HF and LF TENS based on pain assessment using various pain scales. This reflects the distinctive effects of different TENS modalities on different aspects of neuropathic pain.

Application of High-Frequency Transcutaneous Electrical Nerve Stimulation in Muscle Tension Dysphonia Patients With the Pain Complaint: The Immediate Effect

<strong><em>Aim: </em></strong><em>The key purpose of our research was to assess efficiency of transcutaneous electrical nervous system stimulation (TENS) by means of the adjunctive to NSAID for pole-procedural aching in cases that endured pleurodesis for pneumothorax.</em> <strong><em>Methodology: </em></strong><em>Our current research was held at Allied Hospital Faisalabad Pakistan from May 2017 to January 2018. Seventy cases in oldness set of 21-61 years, prearranged for pleurodesis in operation theaters (OT) of the current hospital, remained separated into 2 sets of 35 apiece. Cases remained instead allocated to solitary of 2 sets. In Set 1 diclofenac sodium 70 mg in 110 ml of usual saline remained happening 4 afterward process, although transcutaneous nerve stimulation remained practical for 50 mins throughout the current period. In Set 2 (regulator set) diclofenac sodium remained happening afterwards process, also the device equal to transcutaneous nerve stimulation, nonetheless which did not distribute slightly electric current remained practical as dummy. The BP also Heart Rate (HR) remained distinguished at predefined intermissions i.e. directly subsequently process also then at 3, 5, 7 also 9 hours subsequently technique. The 1-12 VAS remained experienced to measure aching at steady intermissions. Once Visual Analog Score remained ≥4, inj. diclofenac sodium 55 mg remained recurrent intramuscularly.</em> <strong><em>Results: </em></strong><em>The SBP remained similar in equally sets directly also 3 h subsequently process nonetheless this remained expressively fewer in Set 1 at 5, 7 in addition 9 hours correspondingly (P&lt;0.06). The Heart rate remained similar in mutually sets instantly subsequently, nonetheless reduced pointedly in Set 1 at 2 hrz (P&lt;1.06), 5 hrz (P&lt;1.03), 7 hrz (P&lt;1.03) also 9 hrz (P&lt;1.03) subsequently technique. The Visual Analogue Score remained similar directly also at 3 hours in mutually sets (P=NS), nevertheless stayed meaningfully fewer in Set 1 at 5, 7 also 9 hours subsequently process (P&lt;0.002). Quantity of diclofenac sodium exercised in Set 1 remained meaningfully fewer as compared in Set 2 (P&lt;0.03).</em> <strong><em>Conclusion: </em></strong><em>Transcutaneous nerve stimulation remains beneficial by way of the adjunctive to NSAIDs for discomfort release in pleurodesis also this give way to decrease in succeeding necessity of NSAIDs. transcutaneous nerve stimulation remains very appreciated strategy to alleviate pain of pleurodesis through not any opposing belongings also through the decent hemodynamic steadiness.</em> <strong>Key Words: </strong><em>Pleurodesis; Sclerosing mediators; Transcutaneous electrical nerve stimulation; transcutaneous nerve stimulation; NSAIDs.</em>

Temporomandibular disorders (TMDs) comprise a number of signs and symptoms affecting the masticatory muscles, temporomandibular joint (TMJ), or both. Because of the multifactorial etiology of such problems, the treatment usually involves more than one modality. Therefore, the aim of this study was to compare the effectiveness of transcutaneous electric nerve stimulation (TENS) and low-level laser therapy for the treatment of patients with TMD. Materials and Methods: The clinical trial was performed with 60 patients diagnosed with TMD of multiple causes. All the patients received both methods of treatment in 6 consecutive weeks. A paired t-test was applied to verify the significance of the results. Results: A significant improvement in the range of motion and pain relief for both the therapies was observed. Comparatively after analyzing the two methods, the values obtained after LLLT were significantly higher than those obtained after TENS therapy (P < 0.01).