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Contralateral segmental transcutaneous electrical nerve stimulation inhibits nociceptive flexion reflex in healthy participants
Author(s) -
Takiguchi Nobuhiro,
Shomoto Koji
Publication year - 2019
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1002/ejp.1373
Subject(s) - transcutaneous electrical nerve stimulation , medicine , anesthesia , visual analogue scale , analgesic , placebo , nociception , stimulation , sural nerve , surgery , receptor , alternative medicine , pathology
Background Transcutaneous electrical nerve stimulation ( TENS ) is a non‐invasive treatment to relieve pain. Contralateral TENS (i.e. TENS administered to the contralateral side of a painful body part) is beneficial when TENS cannot be directly applied to pain site, such as in cases of trauma. Although TENS produces segmental analgesia in an ipsilateral limb, it has been unclear whether TENS produces higher analgesic effects in the contralateral segmental area. The aim of the present study was to investigate the analgesic effects of TENS in contralateral segmental or extra‐segmental areas on physiological and subjective pain outcomes, using a nociceptive flexion reflex ( NFR ) method. Methods We randomly allocated 60 healthy participants to three groups: contralateral segmental TENS ( CS ‐ TENS ); contralateral extra‐segmental TENS ( CE ‐ TENS ); and contralateral placebo TENS ( CP ‐ TENS ). CS ‐ TENS was applied to right superficial sural nerve and CE ‐ TENS was applied to the right superficial femoral nerve, each for 30 minutes. The magnitude of the NFR elicited by electrical stimulation of the left sural nerve was measured at baseline and at three subsequent 10‐minute intervals. Subjective pain intensity was measured simultaneously with a visual analogue scale ( VAS ). Results At 30 min, the NFR magnitude of CS ‐ TENS group was significantly lower than that of the CP ‐ TENS group ( p = 0.021). There were no significant differences in VAS scores among the groups at any time point. Conclusions Our findings suggest that CS ‐ TENS inhibited NFR . Although there was no significant between‐group difference in subjective pain intensity, factors such as a placebo effect probably impacted it. Significance Our findings provide support for the contralateral approach at stimulation sites when TENS cannot be directly administered to a pain site (e.g. due to disease or trauma).