Electrical Currents for Pain Control Vocabulary

Vocabulary flashcards covering electrical stimulation modes, mechanisms, parameters, contraindications, and electrode placements for pain control.

Transcutaneous Electrical Nerve Stimulation (TENS)

A therapeutic intervention that modulates pain using surface electrodes placed on the skin.

Gate Control Theory of Pain

The theory proposed by Melzack and Wall stating that pain transmission at the spinal cord can be inhibited by activating non-nociceptive large A-beta fibers, which closes the gate to noxious signals transmitted by small A-delta and C fibers.

Conventional TENS

High-rate TENS using short pulse durations ($50\text{--}80\,\mu\text{s}$) at $100\text{--}150\,\text{pps}$ with amplitude set to produce a comfortable sensory tingling, selectively activating A-beta fibers without motor activation.

Low-Rate TENS

Also called acupuncture-like TENS; uses longer pulse durations ($200\text{--}300\,\mu\text{s}$) and low frequencies ($2\text{--}10\,\text{pps}$) at higher amplitude to produce visible muscle twitches, stimulating the release of endogenous opioids.

Burst Mode TENS

A TENS mode in which pulses are delivered in packages or bursts (typically preset at $10\,\text{bursts}$), sharing the endorphin-mediated mechanism of low-rate TENS while delivering higher total current.

Electroacupuncture

A treatment technique where electrical current is applied via surface electrodes placed over acupuncture points or directly through inserted acupuncture needles to induce endorphin-mediated pain relief.

Endogenous Opioids

Naturally produced analgesic substances, such as endorphins and enkephalins, whose release is stimulated by low-rate TENS and electroacupuncture to provide post-treatment analgesia lasting $4\text{--}5\,\text{hours}$.

Naloxone

An opioid antagonist whose administration reverses the analgesic effects of electroacupuncture, demonstrating its endorphin-mediated mechanism of action.

Contraindications for TENS Pain Control

Specific medical conditions prohibiting TENS, including demand pacemakers or arrhythmias, placement over the carotid sinus, active thrombosis or thrombophlebitis, and pregnancy over the pelvis, abdomen, or low back.

Precautions for TENS Pain Control

Clinical conditions requiring caution during TENS application, including cardiac disease, impaired mentation or sensation, malignant tumors, and skin irritation or open wounds.

TENS Tolerance

A reduction in analgesic effectiveness that can develop as early as day $4\text{--}5$ of low-rate TENS stimulation, which frequency modulation may delay.

Intersecting Current Electrode Rule

The electrode placement guideline specifying that when intersecting currents cross the site of pain, the electrodes must be separated by at least $1\,\text{inch}$.

A-beta Fibers

Large-diameter, non-nociceptive sensory nerve fibers selectively activated by conventional TENS to inhibit pain transmission at the spinal cord level.

A-delta and C Fibers

Small-diameter nerve fibers responsible for transmitting noxious pain signals to the spinal cord.

Recommended Settings for Pain Control

A reference table specifying pulse frequency, pulse duration, amplitude, modulation, treatment duration, and mechanism of action across conventional, low-rate, and burst TENS modes.

Low Back TENS Electrode Placement

An electrode placement configuration positioned over the lumbar region to control low back pain.

Upper Back and Neck TENS Electrode Placement

An electrode configuration using 2 upper and 2 lower cervical/thoracic electrodes for treating upper back and neck pain.