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Physical approaches to the management of back pain: IV. Transcutaneous Electrical Nerve Stimulation (TENS)* 

Physical approaches to the management of back pain: IV. Transcutaneous Electrical Nerve Stimulation (TENS)*
Chapter:
Physical approaches to the management of back pain: IV. Transcutaneous Electrical Nerve Stimulation (TENS)*
Author(s):

Fran Hall

and Ailsa Wright

DOI:
10.1093/med/9780199609772.003.0008
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date: 23 October 2019

TENS is a form of non-invasive treatment which has been used for treating pain for many years. Small electrodes are placed over the area of the pain which produce a ‘tingling’ sensation which the brain picks up in preference to the pain. It is based upon the Gate Control Theory first postulated by Melzack and Wall in 1965. They proposed that there is a physiological gating mechanism in the dorsal horn of the spinal cord which can be closed in order to inhibit painful impulses travelling through it and ascending to the brain where they are processed and felt as pain. As well as this inhibitory effect on neurons TENS can also affect the extrasegmental, descending pathways from the brain by stimulating small A-delta fibres in muscles which in turn causes a reduction in release of excitory neurotransmitters such as aspartate and glutamate and an increased release of inhibitory neurotransmitters such as GABA and serotonin (...

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