Percutaneous electrical nerve stimulation therapy? Cross culture? Electrical? Nerve? Stimulation (TENS for short)?

I. Definition

Percutaneous nerve electrical stimulation therapy (peripheral nerve coarse fiber electrical stimulation therapy) is an electrotherapy method to treat pain by inputting specific low-frequency pulse current into human body through skin. This is a kind of electrotherapy that emerged in the 1970s, and it has achieved good results in relieving pain, so it has been widely used in clinic (especially in the United States).

Second, physical characteristics

The difference between TENS therapy and traditional nerve stimulation therapy is that traditional electrical stimulation mainly stimulates motor fibers; TENS is used to stimulate sensory fibers.

Third,? Therapeutic mechanism

1. Gating theory holds that TENS is a stimulus that excites crude fiber, and the excitement of crude fiber closes the floodgate of pain, thus alleviating the pain symptoms. Electrophysiological experiments show that a square wave with a frequency of about 100Hz and a wave width of 0. 1ms is a suitable stimulus to stimulate crude fibers.

2. Endogenous morphine-like substance release theory? A certain low-frequency pulse current stimulation may activate endogenous morphine-like polypeptide neurons in the brain, causing the release of endogenous morphine-like polypeptide and producing analgesic effect.

3. Promote local blood circulation: TENS can not only relieve pain, but also promote local blood circulation. After treatment, the local skin temperature increased by 65438 0-2.5℃.

Four, equipment and processing methods

1. The electrode placement method is as follows:

(1) at a special point? That is, trigger points, related acupoints and movement points. Because these special acupoints have low skin resistance and high input density to the central nervous system. These points are effective locations for placing electrodes.

(2) On the same segment of the lesion? Because electrical stimulation can cause the release of endorphins in the same segment to relieve pain.

(3) Placed in the superior cervical ganglion (both sides of C2 transverse process under mastoid) or skull with current can achieve good analgesic effect. 2. The choice of frequency depends on the patient's feeling that it can relieve symptoms.

To promote bone formation, 1-2Hz should be used.

Chronic pain should be treated with 14 ~ 60hz;

Postoperative pain should be 50 ~150hz;

Herpes pain should be treated with 15 ~ 180 Hz;

The pain after peripheral nerve injury is 30 ~ 120 Hz and so on.

It is generally advocated that patients should choose the appropriate frequency. The stimulation frequency of most patients is 100Hz, and the T width is 0.1~ 0.3ms..

3. current intensity? It is advisable to cause obvious tremor without causing pain. General 15 ~ 30ma, depending on the degree of tolerance.

4. Treatment time: treatment of burning neuralgia for 2 ~ 3 minutes. Generally, it is 20 minutes, and it can be as long as 1 hour or several hours.

Verb (abbreviation of verb) main indications and contraindications

Indications: headache, migraine, neuralgia, burning neuralgia, phantom limb pain, joint pain, abdominal pain, postoperative pain, labor pain, cancer pain, etc. TENS is effective for acute, chronic and neuropathic pain, and the short-term treatment effect is higher than the long-term treatment. ? (2) Contraindications

? 1.？ Patients with pacemakers.

2.？ Carotid sinus.

3. Waist and lower abdomen of early pregnant women.

4.？ Patients with local sensory loss and electrical allergy.